go back

Montana rates for HCPCS A4417

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

Facilitymedian $5 · 10th–90th $3–$60%20%40%10th90th$5Professionalmedian $4 · 10th–90th $2–$70%10%20%10th90th$4$1.0$2.0$5.0$10.0$20.0$50.0

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
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $7.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $5.13 / $5.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $5.50 / $5.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $5.50 / $5.50
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $5.13 / $10.00
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.13 / $10.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $4.79 / $6.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.50 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $2.00 / $2.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.19 / $2.95