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Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Alaska rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $22 · 10th–90th $11$400%20%40%10th90th$22Professionalmedian $38 · 10th–90th $11$600%20%10th90th$38$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
Professional
Modifier
Global
Typical Low
$11.48
Median
$30.20
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$26.92
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$22.39
Typical High
$26.92
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$38.02
Typical High
$39.81
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$40.74
Typical High
$120.23
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$38.90
Typical High
$38.90
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$38.90
Typical High
$40.74
Providence
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$41.69
Providence
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$28.18
Typical High
$60.26
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$15.14
Typical High
$15.14
United
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.95
Typical High
$81.28