go back

Ostomy Pouch, Urinary, for Use on Faceplate, Plastic

South Carolina rates for HCPCS A4381

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

Rates data updated July 2026.

Facilitymedian $5 · 10th–90th $3$90%20%10th90th$5Professionalmedian $5 · 10th–90th $3$60%20%10th90th$5$0.1$0.2$1.0$5.0$20.0

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
$5.13
Median
$5.13
Typical High
$5.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$5.13
Typical High
$5.62
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$5.89
Typical High
$6.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$6.61
Typical High
$8.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.39
Median
$3.89
Typical High
$3.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$7.59
Medcost
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$3.24
Typical High
$4.17
Medcost
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$6.03
Typical High
$10.47
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$1.78
Typical High
$2.19
Molina
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
United
Setting
Facility
Modifier
Global
Typical Low
$2.04
Median
$2.51
Typical High
$6.61
United
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$3.09
Typical High
$4.17