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Illinois rates for HCPCS A4389

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

Facilitymedian $9 · 10th–90th $4–$500%20%10th90th$9Professionalmedian $5 · 10th–90th $4–$90%20%10th90th$5$0.1$0.5$2.0$10.0$50.0$200.0

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
$3.98 / $3.98 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $21.88 / $75.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $6.46 / $6.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $9.77
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $9.55
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $10.72 / $20.89
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $3.39 / $8.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $4.37 / $7.08