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Illinois rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Facilitymedian $9 · 10th–90th $5$520%20%10th90th$9Professionalmedian $6 · 10th–90th $4$90%20%10th90th$6$0.1$0.5$2.0$10.0$50.0$200.0

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
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$9.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$5.01
Typical High
$9.33
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$5.25
Typical High
$5.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$23.99
Typical High
$79.43
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$6.76
Typical High
$6.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$10.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$10.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$12.88
Typical High
$19.50
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
Molina
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
United
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$3.55
Typical High
$9.33
United
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$4.57
Typical High
$7.41