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Pennsylvania rates for HCPCS A4393

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

Facilitymedian $9 · 10th–90th $6$120%20%40%10th90th$9Professionalmedian $7 · 10th–90th $5$130%20%10th90th$7$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$6.03 / $9.77 / $9.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $10.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $7.94
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $14.13 / $24.55
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $9.12 / $12.88
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $9.55
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $7.08 / $10.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $18.20 / $25.12
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $128.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $12.02 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.27 / $5.37 / $8.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $6.31 / $12.88