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North Carolina rates for HCPCS A4390

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

Facilitymedian $12 · 10th–90th $5–$290%10%20%10th90th$12Professionalmedian $10 · 10th–90th $6–$110%20%40%10th90th$10$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
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $8.91 / $10.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $13.18 / $14.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.96
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 / $6.92 / $9.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.76 / $9.55
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $11.75 / $19.50
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.27 / $5.25 / $8.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $6.61 / $9.55
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $100.00