go back

Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Texas rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $30 · 10th–90th $19$760%20%10th90th$30Professionalmedian $24 · 10th–90th $16$350%20%10th90th$24$0.5$2.0$10.0$50.0$200.0$1.0K

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
$19.50
Median
$25.70
Typical High
$28.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$25.70
Typical High
$34.67
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$28.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$25.12
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$54.95
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$33.11
Typical High
$54.95
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.88
Typical High
$39.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$81.28
Providence
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$31.62
Typical High
$54.95
Providence
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$22.39
Typical High
$22.39
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$17.78
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$18.20
Typical High
$23.99
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$39.81
Typical High
$53.70