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

North Dakota 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?

$12.88

Typical negotiated rate. In North Dakota, October 2026.

Insurers have agreed to pay about $12.88 for this service. The price depends on where it is billed: about $12.88 from a physician practice, and about $9.77 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$12.88$9.77 to $15.14
FacilityA hospital or hospital-owned outpatient department$9.77$9.77 to $10.00

How much rates vary

Facilitymedian $10 · 10th to 90th $9 to $30Professionalmedian $13 · 10th to 90th $6 to $15
$5$10$20$50facility $10professional $13

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
Facility
Modifier
None
Typical Low
$9.77
Median
$9.77
Typical High
$9.77
Aetna
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$9.77
Typical High
$10.00
BCBS North Dakota
Setting
Professional
Modifier
None
Typical Low
$11.22
Median
$15.14
Typical High
$15.14
BCBS North Dakota
Setting
Professional
Modifier
22 · Increased work
Typical Low
$13.49
Median
$18.20
Typical High
$18.20
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Cigna
Setting
Professional
Modifier
None
Typical Low
$8.51
Median
$15.49
Typical High
$19.05
Medica
Setting
Facility
Modifier
None
Typical Low
$6.61
Median
$9.77
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$5.37
Median
$6.31
Typical High
$10.96
United
Setting
Professional
Modifier
None
Typical Low
$4.47
Median
$6.31
Typical High
$10.96

Where North Dakota 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.

North Dakota· 7th of 51

$12.88

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.