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Tennessee rates for HCPCS A4412

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), without filter, each

Facilitymedian $3 · 10th–90th $1–$850%20%40%10th90th$3Professionalmedian $2 · 10th–90th $1–$30%20%40%10th90th$2$1.0$2.0$5.0$10.0$20.0$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
$1.00 / $2.19 / $3.39
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $3.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $2.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $2.29
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $28.18 / $28.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $1.58 / $2.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $1.78 / $2.19