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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Illinois rates for HCPCS A4391

Ostomy pouch, urinary, with extended wear barrier attached (one piece), each

Rates data updated July 2026.

How much does Ostomy Pouch, Urinary, One-Piece, Extended Wear cost?

$6.61

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $6.61 for this service. The price depends on where it is billed: about $6.61 from a physician practice, and about $10.00 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 7 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$6.61$5.50 to $8.32
FacilityA hospital or hospital-owned outpatient department$10.00$5.50 to $26.30

How much rates vary

Facilitymedian $10 · 10th to 90th $5 to $54Professionalmedian $7 · 10th to 90th $5 to $10
$5$10$20$50$100facility $10professional $7

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
$5.50
Median
$5.50
Typical High
$10.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$6.17
Typical High
$10.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$6.46
BCBS
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$27.54
Typical High
$85.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$7.59
Typical High
$7.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$10.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$10.96
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$14.13
Typical High
$18.62
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$4.47
United
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$10.00
Typical High
$10.00
United
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$4.90
Typical High
$8.71

Where Illinois 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.

Illinois· 26th of 51

$6.61

HI $10.96CO $4.90

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.