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Ostomy Pouch, Closed, One-Piece, Convex

Pennsylvania 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?

$1.95

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1.95 for this service. The price depends on where it is billed: about $1.95 from a physician practice, and about $2.45 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 9 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$1.95$1.70 to $2.51
FacilityA hospital or hospital-owned outpatient department$2.45$1.55 to $18.20

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $31Professionalmedian $2 · 10th to 90th $2 to $3
$1$10$100$1K$10Kfacility $2professional $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
$1.55
Median
$1.55
Typical High
$2.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$1.95
Typical High
$2.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$1.91
Typical High
$4.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$1.62
Typical High
$1.91
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$4.17
Typical High
$6.03
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$3.24
Typical High
$3.24
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$2.24
Typical High
$3.24
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$2.45
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1.55
Median
$1.95
Typical High
$2.57
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$2.88
Typical High
$2.88
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$20.89
Typical High
$33.88
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$3.02
Typical High
$4.17
United
Setting
Facility
Modifier
Global
Typical Low
$1.07
Median
$2.00
Typical High
$3.98
United
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.91
Typical High
$4.07

Where Pennsylvania 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.

Pennsylvania· 45th of 51

$1.95

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.