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Rhode Island rates for HCPCS A4390

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

Facilitymedian $25 · 10th–90th $8–$310%10%20%10th90th$25Professionalmedian $7 · 10th–90th $5–$140%20%10th90th$7$5.0$10.0$20.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $27.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $26.92 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $7.08 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $9.12 / $9.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $8.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $7.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $7.76 / $11.22