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Washington rates for HCPCS A4417

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

Facilitymedian $5 · 10th–90th $3$100%20%10th90th$5Professionalmedian $3 · 10th–90th $2$70%10%20%10th90th$3$0.1$0.2$1.0$5.0$20.0

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 / $6.92
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.02 / $7.08
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $4.47
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $5.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.39 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.39
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $6.03 / $10.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $6.61 / $10.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $3.98 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.68 / $5.13 / $5.25
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.25 / $5.25 / $5.75
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $4.57 / $8.51
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $5.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $4.47 / $5.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.34 / $3.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.19 / $4.27
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $4.47 / $7.94