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Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Vermont rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $18 · 10th–90th $13$270%20%40%10th90th$18Professionalmedian $27 · 10th–90th $21$370%20%40%10th90th$27$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$26.92
Typical High
$37.15
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
$26.30
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$38.90
United
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$13.80
Typical High
$17.78
United
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$24.55
Typical High
$79.43