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

Oregon 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?

$12.02

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $12.02 for this service. The price depends on where it is billed: about $10.23 from a physician practice, and about $13.18 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 8 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$10.23$6.92 to $13.18
FacilityA hospital or hospital-owned outpatient department$13.18$12.02 to $13.49

How much rates vary

Facilitymedian $13 · 10th to 90th $11 to $13Professionalmedian $10 · 10th to 90th $4 to $15
$5$10$20$50facility $13professional $10

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
$20.89
Median
$20.89
Typical High
$20.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$6.92
Typical High
$10.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$6.92
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$25.12
Typical High
$28.84
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$10.47
Typical High
$14.13
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.72
Typical High
$15.14
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$13.18
Typical High
$13.49
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$13.49
Median
$13.49
Typical High
$13.49
Providence
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$12.02
Typical High
$16.22
Providence
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$12.88
Typical High
$79.43
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$15.14
Typical High
$15.14
United
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$5.25
Typical High
$8.51
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$5.75
Typical High
$10.96

Where Oregon 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.

Oregon· 7th of 51

$12.02

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.