go back

Washington rates for HCPCS A4425

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.84 / $6.45 / $6.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $2.84 / $6.79
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $3.50 / $3.50
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.38 / $80.00 / $80.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.61 / $4.42 / $24.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $3.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.73 / $5.00 / $8.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.08 / $5.09 / $9.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.45 / $3.84 / $4.22
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.49 / $4.88 / $5.00
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.49 / $5.00 / $5.50
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.15 / $4.38 / $8.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.15 / $4.73 / $7.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $4.25 / $5.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.12 / $4.05
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $2.46 / $2.50