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Gastrostomy/Jejunostomy Tube, Standard

Ohio rates for HCPCS B4087

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

Rates data updated July 2026.

Facilitymedian $34 · 10th–90th $33$410%50%10th90th$34Professionalmedian $24 · 10th–90th $23$380%50%10th90th$24$0.5$2.0$10.0$50.0$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
$23.99
Median
$23.99
Typical High
$33.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$23.99
Typical High
$23.99
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$34.67
Typical High
$51.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$28.84
Typical High
$53.70
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
$21.88
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$18.62
Typical High
$31.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$37.15
Typical High
$42.66
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$46.77
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$33.88
United
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$35.48
Typical High
$58.88