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Illinois rates for HCPCS A4392

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

Facilitymedian $12 · 10th–90th $6–$630%10%20%10th90th$12Professionalmedian $7 · 10th–90th $4–$130%20%10th90th$7$0.1$0.5$2.0$10.0$50.0$200.0

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 / $6.03 / $11.75
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $11.75
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $29.51 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $8.51 / $8.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $12.59
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $16.60 / $21.38
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $14.79 / $14.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $5.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $4.47 / $11.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $5.75 / $9.33