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California rates for HCPCS A4389

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

Facilitymedian $4 · 10th–90th $3$120%20%10th90th$4Professionalmedian $5 · 10th–90th $3$330%20%10th90th$5$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $5.01 / $33.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.24 / $4.17 / $10.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.57 / $12.30
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $12.02 / $18.20
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $16.22 / $32.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.25 / $5.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $5.75
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $9.12 / $12.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $7.94 / $15.85
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $64.57 / $64.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $8.13 / $11.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $8.51
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $16.22
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.47 / $17.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.62 / $3.39 / $4.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $3.89 / $9.33