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Wisconsin rates for HCPCS A4412

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

Facilitymedian $4 · 10th–90th $4$70%20%40%10th90th$4Professionalmedian $3 · 10th–90th $2$60%20%10th90th$3$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $6.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $3.63 / $4.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $11.48 / $18.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $5.62 / $7.24
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $3.31 / $5.50
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $6.92 / $8.51
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.19 / $3.80 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.58 / $1.86 / $4.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.34 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $6.03
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $4.37 / $7.59
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.75 / $10.47
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $8.71 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $3.89 / $18.62
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $3.89
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $3.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $1.74 / $2.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.86 / $3.02