Ostomy belt for peristomal hernia support at Medical City Arlington

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.

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Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Ostomy belt with peristomal hernia support

RED OAK, TX

See all hospitals reporting HCPCS A4396 →

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How this price compares nationally

Medical City Arlington’s median price of $61 is 4% above the median hospital's median price ($58), higher than 67% of the 658 hospitals reporting HCPCS A4396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A4396 at Medical City Arlington

Negotiated rates from the hospital’s own file: 9 payers, 32 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 blueadvantagehmo fee schedule · outpatient	$49.38	$49.38	$49.38 – $49.38
2	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$49.38	$49.38	$49.38 – $49.38
3	Humana tricare fee schedule · outpatient	$55.96	$55.96	$55.96 – $55.96
4	Blue Cross Blue Shield bluepremier fee schedule · outpatient	$55.97	$55.97	$55.97 – $55.97
5	Blue Cross Blue Shield mcrppo fee schedule · outpatient	$56.56	$56.56	$56.56 – $56.56
6	Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient	$56.56	$56.56	$56.56 – $56.56
7	Devoted hmo fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
8	Devoted mcr fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
9	Devoted mme fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
10	Devoted pos fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
11	Devoted ppo fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
12	Devoted snp fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
13	Humana mgmcr fee schedule · outpatient	$57.69	$57.69	$57.69 – $57.69
14	UnitedHealthcare mgmcr fee schedule · outpatient	$57.98	$57.98	$57.98 – $57.98
15	Aetna mcr fee schedule · outpatient	$58.18	$58.18	$58.18 – $58.18
16	Cigna Healthspring mgmcr fee schedule · outpatient	$58.84	$58.84	$58.84 – $58.84
17	WellCare mgmcr fee schedule · outpatient	$59.42	$59.42	$59.42 – $59.42
18	Superior Healthplan mgmcrdualeligible fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
19	Superior Healthplan mgmcrhmo fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
20	Superior Healthplan mgmcrpffs fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
21	Superior Healthplan mgmcrpos fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
22	Superior Healthplan mgmcrppo fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
23	Superior Healthplan mgmcrsnp fee schedule · outpatient	$60.57	$60.57	$60.57 – $60.57
24	Molina mcr fee schedule · outpatient	$62.88	$62.88	$62.88 – $62.88
25	Molina mme fee schedule · outpatient	$62.88	$62.88	$62.88 – $62.88

Page 1 of 2 · 32 rates

Last updated: Mar 1, 2026

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