Drainable ostomy pouch with plastic faceplate

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Drainable plstic pch w/o fp

Payers reporting HCPCS A4377

Payer pricing summary

Low

Average

Median

High

$42

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	299	$6	$9	$10	105%	—	$3 – $47
2	UnitedHealthcare fee schedule · outpatient · +10 other terms	288	$6	$6	$1	13%	—	$3 – $7
3	Aetna fee schedule · outpatient · +7 other terms	265	$6	$7	$3	48%	—	$3 – $37
4	WellCare fee schedule · outpatient · +4 other terms	184	$6	$7	$1	16%	—	$6 – $12
5	Blue Cross Blue Shield fee schedule · outpatient · +7 other terms	181	$6	$8	$4	52%	—	$0 – $28
6	Devoted fee schedule · outpatient · +2 other terms	163	$6	$6	$0	2%	—	$6 – $6
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$6	$6	$0	3%	—	$6 – $7
8	Molina fee schedule · outpatient · +4 other terms	96	$8	$8	$3	39%	—	$5 – $16
9	Cigna fee schedule · outpatient · +6 other terms	77	$6	$7	$2	24%	—	$6 – $15
10	Anthem fee schedule · outpatient · +7 other terms	73	$6	$6	$0	8%	—	$6 – $10
11	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$6	$6	$0	0%	—	$6 – $6
12	Kaiser fee schedule · outpatient · +4 other terms	39	$6	$6	$0	2%	—	$6 – $6
13	Clover fee schedule · outpatient · +1 other terms	37	$6	$6	$0	3%	—	$6 – $6
14	Bcbs Tx fee schedule · outpatient	31	$6	$6	$2	29%	—	$4 – $21
15	Optum fee schedule · outpatient · +1 other terms	25	$6	$7	$3	42%	—	$6 – $15
16	Oscar fee schedule · outpatient · +2 other terms	24	$6	$6	$0	3%	—	$6 – $6
17	Caresource facility · case rate · outpatient · +4 other terms	20	$15	$15	$5	32%	—	$6 – $27
18	Medicare fee schedule · outpatient	18	$6	$6	$0	1%	—	$6 – $6
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$7	$7	$0	2%	—	$7 – $7
20	Wellmark fee schedule · both · +1 other terms	13	$5	$5	$0	3%	—	$4 – $5
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$3	$4	$2	37%	—	$3 – $6
22	Ambetter case rate · outpatient · +5 other terms	12	$9	$9	$0	4%	—	$9 – $10
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$5	$4	$3	73%	—	$0 – $7
24	Bcbs Nj fee schedule · outpatient	12	$6	$13	$9	68%	—	$6 – $27
25	Highmark fee schedule · outpatient · +4 other terms	10	$6	$6	$2	36%	—	$3 – $14

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