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

Hawaii 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?

$14.79

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $14.79 for this service. Most negotiated rates run $10.96 to $15.49.

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 $11 · 10th to 90th $9 to $11Professionalmedian $15 · 10th to 90th $11 to $16
$10facility $11professional $15

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
Professional
Modifier
None
Typical Low
$6.61
Median
$6.61
Typical High
$6.61
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.51
Median
$11.48
Typical High
$11.48
Cigna
Setting
Professional
Modifier
None
Typical Low
$15.85
Median
$15.85
Typical High
$15.85
HMSA
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$14.79
Typical High
$15.49
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$14.79
Typical High
$19.05
United
Setting
Professional
Modifier
None
Typical Low
$10.47
Median
$15.85
Typical High
$15.85
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$10.96
Typical High
$10.96

Where Hawaii 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.

Hawaii· 1st of 51

$14.79

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.