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Gastrostomy/Jejunostomy Tube, Low-Profile

Pennsylvania rates for HCPCS B4088

Gastrostomy/jejunostomy tube, low-profile, any material, any type, each

Rates data updated October 2026.

How much does Gastrostomy/Jejunostomy Tube, Low-Profile cost?

$27.54

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $27.54 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $102 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$25.70$25.12 to $34.67
FacilityA hospital or hospital-owned outpatient department$102$37.15 to $200

How much rates vary

Facilitymedian $102 · 10th to 90th $28 to $4,266Professionalmedian $26 · 10th to 90th $23 to $41
$100$1K$10K$100Kfacility $102professional $26

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$27.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$25.12
Typical High
$32.36
Ambetter
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$37.15
Typical High
$37.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$147.91
Typical High
$223.87
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$27.54
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$25.12
Typical High
$27.54
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$33.11
Median
$151.36
Typical High
$257.04
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$33.11
Typical High
$37.15
United
Setting
Facility
Modifier
None
Typical Low
$46.77
Median
$46.77
Typical High
$56.23
United
Setting
Professional
Modifier
None
Typical Low
$13.80
Median
$36.31
Typical High
$57.54

Where Pennsylvania sits

The same service costs 7.1 times more in North Dakota than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 46th of 51

$27.54

ND $162OH $22.91

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.