go back

Montana rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Facilitymedian $3 · 10th–90th $3–$50%20%40%10th90th$3Professionalmedian $2 · 10th–90th $1–$60%20%10th90th$2$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
$1.00 / $2.00 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $3.31 / $3.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $3.31 / $3.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $3.09 / $6.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $3.09 / $6.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $3.24 / $4.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $3.31 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.07 / $1.20 / $1.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.32 / $2.75