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Wisconsin rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), 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 / $6.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $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 / $7.41
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $3.31 / $5.62
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $6.61 / $7.94
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.19 / $3.89 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.91 / $4.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $6.17 / $6.17
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $4.47 / $7.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.89 / $10.47
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $7.76 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.95 / $3.89 / $19.05
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
$1.26 / $1.74 / $2.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.91 / $3.09