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Wisconsin rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Facilitymedian $8 · 10th–90th $7$140%20%40%10th90th$8Professionalmedian $6 · 10th–90th $4$120%20%10th90th$6$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
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $6.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $12.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.24 / $8.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $23.99 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $11.22 / $14.79
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $6.61 / $11.22
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $14.13 / $16.98
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $7.76 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.80 / $8.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $8.91 / $15.49
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $11.75 / $20.89
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $15.49 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $7.76 / $38.02
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $3.47 / $5.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $3.80 / $6.17