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

West Virginia rates for HCPCS A4390

Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (one piece), each

Rates data updated July 2026.

Facilitymedian $7 · 10th–90th $7$180%50%90th$7Professionalmedian $8 · 10th–90th $7$90%20%40%10th90th$8$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$7.41
Median
$7.41
Typical High
$7.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$8.32
Typical High
$9.12
CareSource
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$8.71
Typical High
$18.20
CareSource
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$16.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$18.62
Typical High
$18.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$66.07
United
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$5.13
Typical High
$8.71
United
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$7.76
Typical High
$11.48