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Idaho rates for HCPCS A4390

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

Facilitymedian $12 · 10th–90th $5–$190%20%10th90th$12Professionalmedian $9 · 10th–90th $5–$150%10%10th90th$9$5.0$10.0$20.0

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
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $7.94 / $18.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.55 / $12.88 / $21.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $15.14 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $9.55
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $12.59 / $18.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $12.88 / $14.45
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $14.45
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $13.80 / $13.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $5.25 / $7.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.75 / $7.76