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Michigan rates for HCPCS A4390

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

Facilitymedian $14 · 10th–90th $6$620%10%20%10th90th$14Professionalmedian $9 · 10th–90th $6$130%10%20%10th90th$9$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
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $40.74 / $77.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $14.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $8.51 / $9.55
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $9.33 / $28.18
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $10.96 / $16.98
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.51
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $8.51 / $9.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $5.13 / $8.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $9.55