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Gastrostomy/Jejunostomy Tube, Standard

New York rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $32 · 10th–90th $23$420%20%40%10th90th$32Professionalmedian $27 · 10th–90th $20$690%20%10th90th$27$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$16.98
Median
$22.91
Typical High
$39.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$22.91
Typical High
$25.12
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$63.10
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$72.44
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$165.96
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$53.70
Typical High
$123.03
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$57.54
Typical High
$89.13
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$32.36
Typical High
$32.36
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$33.11
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$31.62
Typical High
$58.88
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
$38.90
Typical High
$70.79
Univera
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$32.36
Univera
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$33.11