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Ostomy Pouch, Drainable, One-Piece, Convex

New Hampshire rates for HCPCS A4389

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

Rates data updated July 2026.

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

$5.25

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $5.25 for this service. The price depends on where it is billed: about $5.50 from a physician practice, and about $4.57 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$5.50$4.37 to $7.59
FacilityA hospital or hospital-owned outpatient department$4.57$4.57 to $5.50

How much rates vary

Facilitymedian $5 · 10th to 90th $3 to $5Professionalmedian $5 · 10th to 90th $4 to $8
$5$10$20facility $5professional $5

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
$4.57
Median
$4.57
Typical High
$5.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$4.57
Typical High
$5.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.25
Median
$5.25
Typical High
$6.92
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$5.75
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$14.13
United
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$3.39
Typical High
$3.63
United
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$5.01
Typical High
$7.59
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$11.48
Typical High
$17.38

Where New Hampshire sits

The same service costs 2.2 times more in Hawaii 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.

New Hampshire· 42nd of 51

$5.25

HI $9.55CO $4.37

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.