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Pennsylvania rates for HCPCS A4428

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

Facilitymedian $6 · 10th–90th $4–$70%20%40%10th90th$6Professionalmedian $5 · 10th–90th $3–$90%20%40%10th90th$5$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$3.98 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.94
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $5.75
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $10.23 / $17.78
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $6.46 / $9.33
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $6.31 / $6.76
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $5.01 / $7.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $12.88 / $18.20
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $8.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $7.59 / $8.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.09 / $3.80 / $5.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.57 / $9.33