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Washington rates for HCPCS A4392

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

Facilitymedian $11 · 10th–90th $7$220%20%10th90th$11Professionalmedian $8 · 10th–90th $4$160%10%10th90th$8$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
$6.03 / $6.03 / $15.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $6.03 / $15.14
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $7.41 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $7.41
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.76 / $13.49 / $23.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $14.45 / $23.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $8.71 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $11.22 / $11.48
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $11.48 / $13.80
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.55 / $10.00 / $18.62
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $11.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $10.00 / $12.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $4.90 / $7.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $5.13 / $9.33
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $10.00 / $17.38