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Pennsylvania rates for HCPCS A4390

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

Facilitymedian $9 · 10th–90th $6–$100%20%10th90th$9Professionalmedian $8 · 10th–90th $5–$130%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
$6.03 / $10.47 / $10.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.94 / $12.02
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $8.71 / $8.71
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $8.51
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $15.14 / $25.70
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $13.80 / $13.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $9.55 / $13.80
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $10.00
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.94 / $10.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.05 / $26.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $9.55 / $12.88
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $10.00 / $15.85
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $5.62 / $8.51
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $6.76 / $13.80