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Massachusetts rates for HCPCS A4428

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

Facilitymedian $4 · 10th–90th $3–$790%20%40%10th90th$4Professionalmedian $6 · 10th–90th $3–$90%20%10th90th$6$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.94
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $8.91 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $7.08 / $10.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $7.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $6.17
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $12.02
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $4.37
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $8.91 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $7.08 / $10.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $3.89 / $5.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $5.62 / $7.94