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Wisconsin rates for HCPCS A4419

Ostomy pouch, closed; for use on barrier with nonlocking flange, with filter (two piece), each

Facilitymedian $2 · 10th–90th $2–$40%20%40%10th90th$2Professionalmedian $2 · 10th–90th $1–$40%20%10th90th$2$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
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $4.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.29 / $2.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $7.41 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $3.31 / $4.68
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $2.09 / $3.47
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $4.37 / $5.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $2.40 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.02 / $1.20 / $2.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $3.89
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $2.75 / $4.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $3.72 / $6.31
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $4.90 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.23 / $2.45 / $12.02
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $2.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.79 / $1.10 / $1.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $1.20 / $1.95