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Ostomy Pouch, Closed, One-Piece, Convex

Montana 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?

$2.75

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $2.75 for this service. The price depends on where it is billed: about $2.69 from a physician practice, and about $3.09 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 5 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$2.69$2.51 to $3.31
FacilityA hospital or hospital-owned outpatient department$3.09$2.63 to $3.31

How much rates vary

Facilitymedian $3 · 10th to 90th $3 to $5Professionalmedian $3 · 10th to 90th $1 to $14
$2$5$10$20$50facility $3professional $3

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
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.51
Typical High
$13.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$3.31
Typical High
$3.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$3.31
Typical High
$3.31
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2.63
Median
$3.09
Typical High
$6.03
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$3.09
Typical High
$6.03
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.82
Median
$3.24
Typical High
$4.47
Providence
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$3.31
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$1.07
Median
$1.20
Typical High
$1.23
United
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.32
Typical High
$2.75

Where Montana 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.

Montana· 11th of 51

$2.75

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.