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Ostomy Pouch, Closed, One-Piece, Convex

Illinois rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Rates data updated July 2026.

How much does Ostomy Pouch, Closed, One-Piece, Convex cost?

$2.09

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $2.09 for this service. The price depends on where it is billed: about $2.09 from a physician practice, and about $3.24 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.09$1.78 to $3.16
FacilityA hospital or hospital-owned outpatient department$3.24$1.78 to $12.59

How much rates vary

Facilitymedian $3 · 10th to 90th $2 to $20Professionalmedian $2 · 10th to 90th $2 to $4
$2$5$10$20facility $3professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.78
Median
$1.78
Typical High
$3.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.00
Typical High
$3.24
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$13.49
Typical High
$27.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$2.40
Typical High
$2.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$1.91
Typical High
$3.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$1.62
Typical High
$3.72
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$4.79
Typical High
$6.17
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$4.07
Typical High
$4.07
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$2.34
Typical High
$2.34
United
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$3.24
Typical High
$3.24
United
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.78
Typical High
$3.63

Where Illinois sits

The same service costs 2.1 times more in California than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 36th of 51

$2.09

CA $3.55CO $1.66

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.