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Oregon rates for HCPCS A4387

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

Facilitymedian $3 · 10th–90th $2–$50%20%10th90th$3Professionalmedian $2 · 10th–90th $1–$40%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
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $1.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $6.03 / $6.92
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.40 / $3.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $2.88 / $3.39
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.09 / $3.16 / $4.79
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $3.16 / $3.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $2.95 / $4.27
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $79.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $3.55 / $3.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $1.48 / $2.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.32 / $2.63