go back

Texas rates for HCPCS A4377

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

Facilitymedian $5 · 10th–90th $3$170%10%20%10th90th$5Professionalmedian $3 · 10th–90th $2$50%20%40%10th90th$3$0.1$0.5$5.0$50.0$500.0

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 / $3.98
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
$3.16 / $3.16 / $3.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $3.24
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $79.43
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 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $44.67
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $5.01 / $8.71
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $3.02 / $5.75
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $4.07 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $4.79 / $8.51
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $3.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $2.40 / $3.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.75 / $3.63
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $6.17 / $6.17