go back

Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Idaho rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $36 · 10th–90th $15$590%10%10th90th$36Professionalmedian $29 · 10th–90th $11$540%10%10th90th$29$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
$26.92
Typical High
$53.70
BCBS
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$37.15
Typical High
$63.10
BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$44.67
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$26.30
Typical High
$27.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$22.39
Typical High
$26.30
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$35.48
Typical High
$53.70
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$38.02
Typical High
$39.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$30.20
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$44.67
Select Health
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$60.26
Select Health
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$38.02
Typical High
$43.65
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$15.14
Typical High
$25.12
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$16.60
Typical High
$22.39