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Illinois rates for HCPCS A4377

Ostomy pouch, drainable, for use on faceplate, plastic, each

Facilitymedian $6 · 10th–90th $3$350%10%20%10th90th$6Professionalmedian $3 · 10th–90th $2$70%20%10th90th$3$0.1$0.2$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $6.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $6.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $16.22 / $52.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $4.47 / $4.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $7.08
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $9.55 / $12.88
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $2.69 / $2.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $2.34 / $6.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $3.02 / $4.90