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Minnesota rates for HCPCS A4392

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

Facilitymedian $26 · 10th–90th $7–$830%10%10th90th$26Professionalmedian $11 · 10th–90th $6–$130%20%40%10th90th$11$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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.08 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $13.49 / $19.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $11.48 / $11.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $42.66 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $14.79 / $16.60
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $41.69 / $83.18
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $14.45
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.90 / $11.48 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.79 / $12.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $4.37 / $4.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $5.75 / $15.85