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Massachusetts rates for HCPCS A4392

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

Facilitymedian $6 · 10th–90th $4$790%20%40%10th90th$6Professionalmedian $8 · 10th–90th $4$110%20%10th90th$8$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $10.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $11.22 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $8.91 / $12.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.13 / $6.92 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $7.94
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $15.14
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $5.75
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $11.22 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $8.91 / $12.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $4.79 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.92 / $10.00