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Texas rates for HCPCS A4389

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

Facilitymedian $7 · 10th–90th $3$230%10%20%10th90th$7Professionalmedian $5 · 10th–90th $3$70%20%40%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
$2.75 / $3.47 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $8.71 / $23.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $4.17 / $4.68
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $7.08 / $10.72
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $79.43
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 / $4.47 / $5.25
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $64.57 / $64.57
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $7.08 / $12.30
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $5.01 / $8.32
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $6.92 / $12.30
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $5.37
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.75 / $3.47 / $5.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.98 / $5.25
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $8.91 / $8.91