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

Minnesota 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?

$13.49

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $13.49 for this service. The price depends on where it is billed: about $13.49 from a physician practice, and about $39.81 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$13.49$10.96 to $13.49
FacilityA hospital or hospital-owned outpatient department$39.81$14.79 to $57.54

How much rates vary

Facilitymedian $40 · 10th to 90th $9 to $107Professionalmedian $13 · 10th to 90th $9 to $15
$5$10$20$50$100facility $40professional $13

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
Facility
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$8.51
Typical High
$11.22
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$15.85
Typical High
$22.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$13.49
Typical High
$13.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$50.12
Typical High
$138.04
Cigna
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$17.38
Typical High
$19.50
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$54.95
Typical High
$107.15
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$17.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$13.49
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.75
Typical High
$14.79
United
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$5.13
Typical High
$6.17
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$6.76
Typical High
$18.62

Where Minnesota 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.

Minnesota· 3rd of 51

$13.49

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.