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Montana rates for HCPCS A4392

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

Facilitymedian $11 · 10th–90th $7–$140%20%40%10th90th$11Professionalmedian $9 · 10th–90th $4–$150%10%10th90th$9$5.0$10.0$20.0$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
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $7.94 / $15.14
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.22 / $11.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $12.02 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $12.02 / $12.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $11.22 / $21.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $11.22 / $21.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $9.12 / $13.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $12.02 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $4.37 / $4.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.79 / $6.61