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Montana rates for HCPCS A4377

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

Facilitymedian $6 · 10th–90th $4–$70%20%10th90th$6Professionalmedian $5 · 10th–90th $2–$80%10%10th90th$5$1.0$2.0$5.0$10.0$20.0$50.0

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
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.98 / $7.94
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $5.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $6.31 / $6.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $6.31 / $6.31
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $5.89 / $11.48
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $5.89 / $11.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $5.50 / $7.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.29 / $2.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.51 / $3.47