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Massachusetts rates for HCPCS A4390

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

Facilitymedian $9 · 10th–90th $5$790%20%40%10th90th$9Professionalmedian $10 · 10th–90th $5$130%20%10th90th$10$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.94
Typical High
$12.02
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$13.18
Typical High
$79.43
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$10.47
Typical High
$15.14
BCBS
Setting
Facility
Modifier
Global
Typical Low
$9.12
Median
$9.12
Typical High
$27.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.51
Typical High
$9.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$9.55
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$17.78
Health New England
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$7.59
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$13.18
Typical High
$79.43
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$10.47
Typical High
$15.14
United
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$5.37
Typical High
$7.76
United
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$8.51
Typical High
$11.75