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Texas rates for HCPCS A4387

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

Facilitymedian $3 · 10th–90th $2$890%10%20%10th90th$3Professionalmedian $2 · 10th–90th $1$20%20%40%10th90th$2$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
$1.58 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $2.34
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $3.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $1.51
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $1.91
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $23.44 / $23.44
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $3.24 / $4.90
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.02
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $3.24 / $4.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $1.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $2.00 / $3.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.55 / $3.98
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $3.24 / $3.24