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Pennsylvania rates for HCPCS A4389

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

Facilitymedian $6 · 10th–90th $4–$80%20%10th90th$6Professionalmedian $5 · 10th–90th $3–$90%20%40%10th90th$5$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$3.98 / $6.76 / $6.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.94
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $8.91
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.62 / $5.62
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $5.75
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $9.77 / $16.98
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $8.91
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $6.17 / $8.91
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $6.03 / $6.46
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $5.62 / $5.62
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $12.30 / $16.98
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $8.32 / $10.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $8.32 / $10.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $3.63 / $5.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $4.37 / $8.91