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Ostomy Pouch, Urinary, with Faceplate Attached, Plastic

New Hampshire rates for HCPCS A4379

Ostomy pouch, urinary, with faceplate attached, plastic, each

Rates data updated July 2026.

Facilitymedian $11 · 10th–90th $8$140%50%10th90th$11Professionalmedian $12 · 10th–90th $9$180%20%10th90th$12$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$10.96
Typical High
$13.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$10.96
Typical High
$13.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$10.47
Typical High
$11.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$16.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$11.75
Typical High
$13.80
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$18.20
Typical High
$33.88
United
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$8.13
Typical High
$8.71
United
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$12.02
Typical High
$18.20
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$28.18