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Gastrostomy/Jejunostomy Tube, Standard

Washington, DC rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $33 · 10th–90th $33$510%50%90th$33Professionalmedian $33 · 10th–90th $33$460%50%90th$33$20.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$58.88
Typical High
$79.43