Urinary ostomy pouch with attached 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

Urinary plastic pouch w fcpl

Payers reporting HCPCS A4379

Payer pricing summary

Low

Average

$24

Median

$22

High

$73

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	299	$21	$33	$34	105%	—	$10 – $165
2	UnitedHealthcare fee schedule · outpatient · +9 other terms	288	$22	$21	$3	15%	—	$5 – $25
3	Aetna fee schedule · outpatient · +7 other terms	265	$22	$23	$11	48%	—	$9 – $130
4	WellCare fee schedule · outpatient · +4 other terms	184	$22	$23	$4	16%	—	$21 – $42
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	181	$22	$26	$14	52%	—	$0 – $99
6	Devoted fee schedule · outpatient · +2 other terms	163	$21	$21	$0	2%	—	$21 – $23
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$22	$22	$1	3%	—	$21 – $23
8	Molina fee schedule · outpatient · +4 other terms	96	$29	$29	$11	39%	—	$18 – $56
9	Cigna fee schedule · outpatient · +5 other terms	77	$22	$24	$6	24%	—	$21 – $54
10	Anthem fee schedule · outpatient · +6 other terms	73	$21	$21	$2	8%	—	$21 – $35
11	Superior Healthplan fee schedule · outpatient	40	$22	$22	$0	0%	—	$21 – $22
12	Kaiser fee schedule · outpatient · +4 other terms	39	$21	$21	$1	2%	—	$21 – $22
13	Clover fee schedule · outpatient · +1 other terms	37	$21	$22	$1	3%	—	$21 – $22
14	Bcbs Tx fee schedule · outpatient	31	$20	$20	$6	29%	—	$15 – $73
15	Optum fee schedule · outpatient · +1 other terms	25	$21	$25	$10	42%	—	$21 – $54
16	Oscar fee schedule · outpatient · +2 other terms	24	$21	$22	$1	3%	—	$21 – $22
17	Caresource facility · case rate · outpatient · +4 other terms	20	$11	$18	$12	66%	—	$7 – $43
18	Medicare fee schedule · outpatient	18	$21	$21	$0	1%	—	$21 – $21
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$26	$25	$1	2%	—	$24 – $26
20	Wellmark fee schedule · both · +1 other terms	13	$19	$19	$1	3%	—	$15 – $19
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$10	$15	$5	37%	—	$10 – $21
22	Ambetter case rate · outpatient · +5 other terms	12	$30	$31	$1	4%	—	$30 – $34
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$18	$12	$10	83%	—	$0 – $23
24	Bcbs Nj fee schedule · outpatient	12	$21	$45	$31	68%	—	$21 – $93
25	Highmark fee schedule · outpatient · +4 other terms	10	$22	$23	$8	36%	—	$10 – $50

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