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Wisconsin rates for HCPCS A4420

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

Facilitymedian $1 · 10th–90th $1–$650%20%40%10th90th$1Professionalmedian $2 · 10th–90th $2–$320%50%90th$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.98 / $3.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $1.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.04 / $2.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.09
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $1.23
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $7.08 / $9.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $1.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $50.12 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.04 / $64.57
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $1.74 / $2.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $2.40