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New York rates for HCPCS A4417

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

Facilitymedian $4 · 10th–90th $2$90%20%10th90th$4Professionalmedian $3 · 10th–90th $2$70%50%10th90th$3$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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 / $4.17 / $5.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $4.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $2.75 / $8.32
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $4.37 / $4.37
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $4.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.63 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $6.03
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $8.71 / $20.42
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $5.62 / $10.00
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $4.07
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $3.89
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $5.13 / $5.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.82 / $2.19 / $5.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $3.47 / $8.71
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $3.80 / $4.07
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $3.80 / $3.89