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Minnesota rates for HCPCS A4390

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

Facilitymedian $31 · 10th–90th $8$980%5%10%10th90th$31Professionalmedian $13 · 10th–90th $7$150%20%40%10th90th$13$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
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$7.94
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.94
Typical High
$10.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$15.85
Typical High
$22.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$13.49
Typical High
$13.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$50.12
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$16.98
Typical High
$19.50
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$48.98
Typical High
$97.72
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$16.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$13.49
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.75
Typical High
$14.79
United
Setting
Facility
Modifier
Global
Typical Low
$0.09
Median
$5.13
Typical High
$5.25
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$6.76
Typical High
$18.62