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Wisconsin 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 $9$170%20%40%10th90th$9Professionalmedian $7 · 10th–90th $5$140%10%20%10th90th$7$5.0$10.0$20.0$50.0$100.0

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
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $7.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $15.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $10.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $28.18 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $13.18 / $17.78
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.13 / $7.94 / $13.18
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $17.78 / $21.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.25 / $9.12 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $4.57 / $10.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $14.79 / $14.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $10.47 / $18.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $13.80 / $23.99
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $18.62 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $9.33 / $45.71
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $4.17 / $6.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $4.57 / $7.41