go back

Massachusetts rates for HCPCS A4393

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

Facilitymedian $9 · 10th–90th $5$790%20%40%10th90th$9Professionalmedian $9 · 10th–90th $5$120%20%10th90th$9$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $10.96
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $12.30 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $9.77 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $26.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $7.59 / $8.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $9.12
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $16.60
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $6.31 / $6.31
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $12.30 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $9.77 / $14.13
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $5.75 / $7.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $7.76 / $10.96