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

Arizona rates for HCPCS A4390

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

Rates data updated July 2026.

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

$8.13

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $8.13 for this service. The price depends on where it is billed: about $8.13 from a physician practice, and about $13.18 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$8.13$5.75 to $10.23
FacilityA hospital or hospital-owned outpatient department$13.18$5.75 to $18.62

How much rates vary

Facilitymedian $13 · 10th to 90th $4 to $30Professionalmedian $8 · 10th to 90th $4 to $14
$5$10$20$50facility $13professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$8.13
Typical High
$11.75
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.72
Median
$15.14
Typical High
$29.51
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$14.13
Typical High
$28.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$8.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$3.72
Median
$10.47
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$5.75
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$5.37
Typical High
$13.80
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$5.75
Typical High
$8.51

Where Arizona 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.

Arizona· 41st of 51

$8.13

HI $14.79CO $6.76

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.