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Illinois rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Facilitymedian $4 · 10th–90th $2–$210%20%10th90th$4Professionalmedian $2 · 10th–90th $1–$40%20%10th90th$2$0.1$0.2$1.0$5.0$20.0$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 / $3.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.89
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $2.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.31 / $10.72 / $33.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.88 / $2.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $4.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $1.95 / $4.27
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.37 / $9.33
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $1.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.05 / $1.51 / $3.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.91 / $3.16