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New York rates for HCPCS A4390

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

Facilitymedian $10 · 10th–90th $5–$220%20%10th90th$10Professionalmedian $8 · 10th–90th $6–$180%20%10th90th$8$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$5.01 / $10.72 / $15.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.94 / $12.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $8.91 / $19.05
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $11.22 / $11.22
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.51 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $15.49
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $22.39 / $52.48
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $13.80 / $25.70
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $8.51 / $8.91
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $9.77 / $9.77
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $13.18 / $13.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.68 / $5.62 / $13.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $8.51 / $22.91
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $9.55 / $9.77
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $9.77 / $9.77