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Texas rates for HCPCS A4392

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

Facilitymedian $10 · 10th–90th $6–$310%10%20%10th90th$10Professionalmedian $7 · 10th–90th $4–$90%20%10th90th$7$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
$2.69 / $7.08 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $7.08 / $8.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $7.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $11.48 / $31.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $6.17
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $9.33 / $14.13
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $6.92
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
$57.54 / $85.11 / $85.11
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.62 / $9.33 / $16.22
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $10.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $9.12 / $16.22
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $7.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $4.57 / $6.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $5.25 / $6.92
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $11.75 / $11.75