go back

Wisconsin rates for HCPCS A4387

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

Facilitymedian $3 · 10th–90th $3$60%20%40%10th90th$3Professionalmedian $2 · 10th–90th $1$50%10%20%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.58 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $5.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $2.95 / $3.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $9.55 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $4.68 / $6.03
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $2.69 / $3.80
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $5.75 / $7.08
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $3.16 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $2.40 / $4.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $3.80 / $7.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.79 / $8.51
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $6.31 / $89.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $3.24 / $15.49
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $3.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $3.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.20 / $1.78 / $3.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.91 / $3.98