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Ohio rates for HCPCS A4391

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

Facilitymedian $6 · 10th–90th $4$100%20%10th90th$6Professionalmedian $6 · 10th–90th $4$90%10%20%10th90th$6$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
$6.03 / $8.32 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $6.03 / $7.94
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $8.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $6.03 / $13.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.90 / $8.32 / $11.75
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $8.91 / $13.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $6.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $6.31
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $6.31
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $6.92 / $10.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $10.96 / $20.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.98 / $6.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.68 / $6.61