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.
Original text from hospital filings
Drainable plastic pch w fcpl
Arlington, TX
See all hospitals reporting HCPCS A4375 →Price type
AMH Cath Labs LLC’s median price of $26 is 4% above the median hospital's median price ($25), higher than 67% of the 667 hospitals reporting HCPCS A4375. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 2 | Humana medicare advantage case rate · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 3 | Humana medicare advantage ppo case rate · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 4 | Molina medicare advantage case rate · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 5 | WellCare medicare advantage hmo case rate · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 6 | WellCare medicare advantage mmp case rate · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 7 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $27 | $27 | — | — | — | $27 – $27 |
| 8 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $28 | $28 | — | — | — | $28 – $28 |
Last updated: Apr 21, 2026
See Drainable ostomy pouch with attached faceplate pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.