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Ostomy Pouch, Urinary, with Faceplate Attached, Plastic

Vermont rates for HCPCS A4379

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

Rates data updated July 2026.

Facilitymedian $10 · 10th–90th $7$140%20%10th90th$10Professionalmedian $14 · 10th–90th $11$200%20%10th90th$14$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$14.13
Typical High
$19.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$14.45
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$11.75
Typical High
$13.80
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$16.60
Typical High
$20.42
United
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$7.41
Typical High
$9.55
United
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$12.88
Typical High
$42.66