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Montana rates for HCPCS A4391

Ostomy pouch, urinary, with extended wear barrier attached (one piece), each

Facilitymedian $10 · 10th–90th $6–$120%20%10th90th$10Professionalmedian $8 · 10th–90th $4–$130%10%10th90th$8$2.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $12.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $9.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $10.47 / $10.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $10.47 / $10.47
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.55 / $18.62
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $9.55 / $18.62
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $9.12 / $11.75
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $10.47 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $3.80 / $3.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.17 / $5.62