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Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Massachusetts rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $27 · 10th–90th $17$1910%20%10th90th$27Professionalmedian $35 · 10th–90th $17$520%20%40%10th90th$35$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$17.38
Median
$17.38
Typical High
$17.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$20.89
Typical High
$79.43
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$38.90
Typical High
$190.55
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$32.36
Typical High
$47.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$27.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$22.39
Typical High
$26.92
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$34.67
Typical High
$52.48
Health New England
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$38.90
Typical High
$190.55
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$32.36
Typical High
$47.86
United
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$16.22
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$32.36
Typical High
$34.67