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Texas rates for HCPCS A4428

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

Facilitymedian $8 · 10th–90th $5$250%20%10th90th$8Professionalmedian $5 · 10th–90th $4$70%20%40%10th90th$5$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$4.57 / $5.01 / $6.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $5.01 / $7.08
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.76 / $9.12 / $25.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $4.90
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $7.41 / $10.23
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $6.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $5.50
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $67.61 / $67.61
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.47 / $7.59 / $13.18
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $8.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $6.76 / $81.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $7.24 / $12.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $5.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $3.63 / $5.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $4.17 / $5.50
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $9.33 / $9.33