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Michigan rates for HCPCS A4389

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

Facilitymedian $9 · 10th–90th $4–$400%10%20%10th90th$9Professionalmedian $5 · 10th–90th $4–$90%10%20%10th90th$5$0.1$0.5$2.0$10.0$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
$6.03 / $6.03 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $7.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $8.91 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $26.30 / $50.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $9.12
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $5.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $5.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.50 / $6.17
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.76 / $7.76 / $18.20
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $10.96
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $5.75
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $5.50 / $6.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.40 / $3.39 / $5.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $4.07 / $6.17