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California rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Facilitymedian $2 · 10th–90th $2$70%20%10th90th$2Professionalmedian $3 · 10th–90th $2$200%20%10th90th$3$0.1$0.2$1.0$5.0$20.0$100.0$500.0

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 / $1.00 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.02 / $19.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.95 / $2.45 / $6.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $2.75 / $7.59
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $7.24 / $10.96
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $9.55 / $19.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $3.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.47
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $5.50 / $7.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $4.79 / $8.71
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
$26.30 / $38.90 / $38.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $5.25
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $4.90 / $7.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $5.13
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $6.17 / $10.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.37 / $2.00 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.34 / $5.62