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Gastrostomy/Jejunostomy Tube, Standard

Illinois rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $34 · 10th–90th $34$1950%50%90th$34Professionalmedian $32 · 10th–90th $22$340%20%40%10th90th$32$20.0$50.0$100.0$200.0$500.0

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
$33.88
Median
$33.88
Typical High
$33.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$30.20
Typical High
$33.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$91.20
Typical High
$323.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$33.88
Typical High
$33.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$56.23
Typical High
$97.72
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
United
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$33.88
Typical High
$33.88
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$37.15
Typical High
$61.66