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Illinois rates for HCPCS A4393

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

Facilitymedian $13 · 10th–90th $7–$710%20%10th90th$13Professionalmedian $8 · 10th–90th $5–$130%20%10th90th$8$0.1$0.5$2.0$10.0$50.0$200.0

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 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.76 / $12.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $32.36 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $9.55 / $9.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $14.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $14.79
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $15.49 / $25.70
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $16.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.47 / $4.90 / $12.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $10.23