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Washington rates for HCPCS A4393

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

Facilitymedian $13 · 10th–90th $7$240%20%10th90th$13Professionalmedian $9 · 10th–90th $5$180%10%10th90th$9$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
$7.08 / $7.08 / $16.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $7.08 / $16.98
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $10.96
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $10.96 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $7.94 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $7.94
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $14.79 / $25.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $16.22 / $25.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $9.77 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $12.30 / $12.59
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $12.59 / $12.59
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $10.96 / $20.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $12.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $10.96 / $14.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.90 / $5.75 / $8.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.90 / $5.62 / $10.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $10.96 / $19.50