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

Florida rates for HCPCS A4390

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

Rates data updated July 2026.

Facilitymedian $10 · 10th–90th $6$110%20%40%10th90th$10Professionalmedian $10 · 10th–90th $6$120%10%20%10th90th$10$0.1$0.5$2.0$10.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$6.03
Median
$9.77
Typical High
$10.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$9.77
Typical High
$11.75
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$7.76
Typical High
$13.49
AvMed
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$11.22
Typical High
$13.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$18.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$8.13
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$6.31
Typical High
$12.88
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$8.13
Typical High
$13.80
Molina
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$7.94
Typical High
$20.89
United
Setting
Facility
Modifier
Global
Typical Low
$4.47
Median
$6.17
Typical High
$13.80
United
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$6.61
Typical High
$8.13
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$13.80