go back

Ostomy Pouch, Urinary, for Use on Faceplate, Rubber

Wisconsin rates for HCPCS A4383

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

Rates data updated July 2026.

Facilitymedian $40 · 10th–90th $32$720%20%40%10th90th$40Professionalmedian $37 · 10th–90th $19$660%10%10th90th$37$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
$22.91
Median
$22.91
Typical High
$22.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$22.91
Typical High
$33.88
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$37.15
Typical High
$44.67
Cigna
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$125.89
Typical High
$204.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$46.77
Typical High
$75.86
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$33.88
Typical High
$57.54
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$30.20
Typical High
$48.98
Medica
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$39.81
Typical High
$186.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$16.60
Median
$19.50
Typical High
$43.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Network Health
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$45.71
Typical High
$79.43
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$33.88
Typical High
$57.54
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$39.81
Quartz
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$60.26
Typical High
$100.00
Quartz
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$81.28
Typical High
$190.55
Quartz
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$26.30
Typical High
$199.53
Security Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Security Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
United
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$17.78
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.50
Typical High
$33.88