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Montana 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 $6–$110%20%40%10th90th$9Professionalmedian $7 · 10th–90th $3–$120%10%10th90th$7$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
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $6.03 / $12.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $9.55 / $9.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $9.55 / $9.55
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $8.91 / $17.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $8.91 / $17.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $8.51 / $10.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $9.55 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.09 / $3.55 / $3.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $3.89 / $5.25