go back

Utah rates for HCPCS A4377

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

Facilitymedian $1 · 10th–90th $1$40%50%90th$1Professionalmedian $4 · 10th–90th $1$260%10%10th90th$4$0.1$0.2$1.0$5.0$20.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.00
Median
$1.00
Typical High
$1.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$3.89
Typical High
$26.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.63
Median
$3.63
Typical High
$3.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.09
Median
$3.09
Typical High
$4.27
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$4.37
Typical High
$5.89
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$6.76
Select Health
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$6.03
Typical High
$6.17
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$6.17
Typical High
$7.41
United
Setting
Facility
Modifier
Global
Typical Low
$2.04
Median
$2.29
Typical High
$2.51
United
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.51
Typical High
$4.57