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Minnesota rates for HCPCS A4377

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

Facilitymedian $14 · 10th–90th $3–$450%10%10th90th$14Professionalmedian $6 · 10th–90th $3–$70%50%10th90th$6$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 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $7.08 / $10.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.03 / $6.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $22.91 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.94 / $9.12
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $22.91 / $44.67
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $6.03 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $2.51 / $7.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.04 / $2.29 / $2.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $8.32