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Gastrostomy/Jejunostomy Tube, Standard

Alaska rates for HCPCS B4087

Gastrostomy/jejunostomy tube, standard, any material, any type, each

Rates data updated July 2026.

Facilitymedian $40 · 10th–90th $24$400%50%10th$40Professionalmedian $40 · 10th–90th $24$1380%20%40%10th90th$40$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$39.81
Typical High
$39.81
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$42.66
Typical High
$134.90
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Providence
Setting
Facility
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$33.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$26.30
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$102.33