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Gastrostomy/Jejunostomy Tube, Standard

Maryland rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $54 · 10th–90th $32$2690%20%10th90th$54Professionalmedian $33 · 10th–90th $17$460%20%40%10th90th$33$20.0$50.0$100.0$200.0$500.0$1.0K

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
$45.71
Median
$53.70
Typical High
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$33.11
Typical High
$45.71
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$18.62
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$35.48
Typical High
$51.29
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$32.36
Typical High
$58.88
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$29.51