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Ostomy Pouch, Urinary, for Use on Faceplate, Plastic

New Mexico rates for HCPCS A4381

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

Rates data updated July 2026.

Facilitymedian $5 · 10th–90th $2$70%10%10th90th$5Professionalmedian $4 · 10th–90th $2$110%20%10th90th$4$2.0$5.0$10.0$20.0$50.0

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
$4.68
Median
$4.68
Typical High
$4.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$4.57
Typical High
$28.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$3.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$9.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$6.46
Typical High
$11.22
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.78
Median
$4.79
Typical High
$7.76
Providence
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$6.76
United
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$2.75
Typical High
$6.61
United
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.75
Typical High
$4.07