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Washington 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$170%20%10th90th$9Professionalmedian $6 · 10th–90th $3$130%10%20%10th90th$6$0.1$0.5$2.0$10.0$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
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$12.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$5.01
Typical High
$12.02
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$7.94
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$10.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.75
Typical High
$5.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$5.75
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$10.47
Typical High
$19.05
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$11.48
Typical High
$19.05
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$6.92
Typical High
$64.57
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.91
Typical High
$9.12
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$9.12
Typical High
$10.47
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$7.94
Typical High
$14.79
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$8.91
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$7.94
Typical High
$10.23
United
Setting
Facility
Modifier
Global
Typical Low
$3.55
Median
$3.89
Typical High
$5.89
United
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$3.89
Typical High
$7.41
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$7.94
Typical High
$13.80