go back

Texas rates for HCPCS A4391

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

Facilitymedian $8 · 10th–90th $5$260%10%20%10th90th$8Professionalmedian $6 · 10th–90th $4$80%20%40%10th90th$6$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$4.90 / $6.03 / $7.08
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
$6.61 / $6.61 / $6.61
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $6.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $5.25
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $8.13 / $12.30
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $74.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $8.13 / $14.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $6.03 / $9.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.90 / $7.94 / $13.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $6.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.98 / $6.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $4.57 / $6.03
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $10.00 / $10.00