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

New Hampshire 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?

$8.13

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $8.13 for this service. The price depends on where it is billed: about $8.32 from a physician practice, and about $7.08 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$8.32$6.76 to $11.75
FacilityA hospital or hospital-owned outpatient department$7.08$7.08 to $8.51

How much rates vary

Facilitymedian $7 · 10th to 90th $5 to $9Professionalmedian $8 · 10th to 90th $6 to $12
$5$10$20facility $7professional $8

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
$7.08
Median
$7.08
Typical High
$8.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$7.08
Typical High
$8.51
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$7.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$10.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$8.51
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$21.88
United
Setting
Facility
Modifier
Global
Typical Low
$3.55
Median
$5.13
Typical High
$5.62
United
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$7.76
Typical High
$11.75
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$17.38
Median
$17.38
Typical High
$17.78

Where New Hampshire 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.

New Hampshire· 44th of 51

$8.13

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.