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

Kentucky 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?

$7.08

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $7.08 for this service. The price depends on where it is billed: about $7.08 from a physician practice, and about $8.51 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$7.08$6.76 to $8.13
FacilityA hospital or hospital-owned outpatient department$8.51$8.13 to $10.00

How much rates vary

Facilitymedian $9 · 10th to 90th $8 to $19Professionalmedian $7 · 10th to 90th $6 to $11
$5$10$20$50facility $9professional $7

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$4.47
Median
$7.59
Typical High
$8.51
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.72
Median
$7.59
Typical High
$8.51
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$6.76
Median
$7.08
Typical High
$9.12
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$0.68
Median
$0.68
Typical High
$0.68
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$5.01
Median
$5.01
Typical High
$7.08
CareSource
Setting
Facility
Modifier
None
Typical Low
$8.71
Median
$12.02
Typical High
$19.50
CareSource
Setting
Professional
Modifier
None
Typical Low
$13.49
Median
$16.60
Typical High
$21.38
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.13
Median
$8.51
Typical High
$18.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$6.92
Median
$8.51
Typical High
$66.07
Molina
Setting
Professional
Modifier
None
Typical Low
$7.94
Median
$10.00
Typical High
$19.05
United
Setting
Professional
Modifier
None
Typical Low
$4.37
Median
$6.03
Typical High
$8.91
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
$0.87
Median
$1.29
Typical High
$1.29
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.59
Median
$0.85
Typical High
$0.85

Where Kentucky 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.

Kentucky· 44th of 51

$7.08

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.