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Ostomy Pouch, Drainable, One-Piece, Extended Wear, Convex

Arkansas rates for HCPCS A4390

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

Rates data updated October 2026.

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

$10.72

Typical negotiated rate. In Arkansas, October 2026.

Insurers have agreed to pay about $10.72 for this service. Most negotiated rates run $6.92 to $16.98.

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.

How much rates vary

Facilitymedian $8 · 10th to 90th $8 to $11Professionalmedian $11 · 10th to 90th $5 to $17
$5$10facility $8professional $11

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Aetna
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$10.72
Typical High
$10.72
Ambetter
Setting
Professional
Modifier
None
Typical Low
$7.59
Median
$7.59
Typical High
$7.59
BCBS Arkansas
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.13
Median
$8.13
Typical High
$8.51
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.07
Median
$6.92
Typical High
$8.13
Qualchoice
Setting
Professional
Modifier
None
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
United
Setting
Professional
Modifier
None
Typical Low
$4.37
Median
$6.31
Typical High
$9.55
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$1.62
Median
$1.62
Typical High
$1.62
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$1.07
Median
$1.07
Typical High
$1.07

Where Arkansas sits

The same service costs 2.1 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.

Arkansas· 16th of 51

$10.72

HI $14.79CO $6.92

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.