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Washington rates for HCPCS A4420

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

Facilitymedian $2 · 10th–90th $2–$20%50%10th$2Professionalmedian $2 · 10th–90th $1–$500%50%10th90th$2$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
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $1.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.17 / $1.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.14
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $1.62
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38