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Nebraska rates for HCPCS A4390

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

Facilitymedian $13 · 10th–90th $5–$790%10%10th90th$13Professionalmedian $10 · 10th–90th $4–$340%10%10th90th$10$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
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $10.96 / $58.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $12.88 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.51 / $15.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $15.49 / $22.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $19.05 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.76 / $13.49
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $14.79 / $36.31
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $33.88 / $36.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $6.17 / $8.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $6.76 / $10.47