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Ostomy Pouch, Drainable, One-Piece, Convex

South Dakota 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?

$7.94

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $7.94 for this service. The price depends on where it is billed: about $7.59 from a physician practice, and about $9.12 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 7 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$7.59$5.89 to $10.23
FacilityA hospital or hospital-owned outpatient department$9.12$6.31 to $10.00

How much rates vary

Facilitymedian $9 · 10th to 90th $5 to $12Professionalmedian $8 · 10th to 90th $5 to $13
$5$10$20$50facility $9professional $8

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$6.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.89
Typical High
$11.75
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.25
Median
$5.25
Typical High
$9.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.23
Typical High
$12.59
Medica
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$9.33
Typical High
$16.22
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$5.50
Typical High
$43.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$9.55
Typical High
$9.55
Midlands
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$9.77
Midlands
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$15.49
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$8.71
Typical High
$11.48
United
Setting
Facility
Modifier
Global
Typical Low
$3.39
Median
$4.07
Typical High
$6.17
United
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$5.75
Typical High
$10.23
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$7.08

Where South Dakota 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.

South Dakota· 5th of 51

$7.94

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.