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Pennsylvania rates for HCPCS B4087

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

Facilitymedian $24 · 10th–90th $20–$540%50%10th90th$24Professionalmedian $24 · 10th–90th $16–$450%20%10th90th$24$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $23.99 / $44.67
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $138.04 / $275.42
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $23.99
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $23.99 / $33.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $33.11 / $33.11
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $33.11 / $53.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $51.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $33.88 / $52.48