go back

Gastrostomy/Jejunostomy Tube, Standard

Michigan rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $34 · 10th–90th $34$3550%50%90th$34Professionalmedian $34 · 10th–90th $22$400%50%10th90th$34$10.0$20.0$50.0$100.0$200.0

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
$95.50
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$33.88
Typical High
$33.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$97.72
Typical High
$190.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.88
Typical High
$33.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$21.88
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$87.10
Typical High
$102.33
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$34.67
Typical High
$45.71
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$21.88
Typical High
$21.88
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$35.48
Typical High
$51.29