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Tennessee rates for HCPCS A4377

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

Facilitymedian $4 · 10th–90th $2–$850%20%40%10th90th$4Professionalmedian $3 · 10th–90th $2–$50%20%40%10th90th$3$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
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $3.47 / $5.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $5.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $4.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $4.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $3.63
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $44.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $2.51 / $3.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $2.82 / $3.55