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Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Tennessee rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $35 · 10th–90th $15$1910%20%40%10th90th$35Professionalmedian $25 · 10th–90th $16$350%10%20%10th90th$25$10.0$20.0$50.0$100.0$200.0

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
$20.42
Median
$22.91
Typical High
$35.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$25.12
Typical High
$34.67
BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$31.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$30.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$22.39
Typical High
$22.39
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$295.12
Typical High
$295.12
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$17.78
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$18.20
Typical High
$22.91