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Ostomy Pouch, Urinary, for Use on Faceplate, Plastic

Hawaii rates for HCPCS A4381

Ostomy pouch, urinary, for use on faceplate, plastic, each

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $2$50%20%10th90th$3Professionalmedian $7 · 10th–90th $3$70%50%10th90th$7$2.0$5.0$10.0

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
$3.16
Median
$3.16
Typical High
$3.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$5.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$6.46
Typical High
$8.71
HMSA
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$7.41
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.08
Typical High
$10.00
United
Setting
Facility
Modifier
Global
Typical Low
$2.09
Median
$2.19
Typical High
$2.51
United
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$4.57
Typical High
$8.71