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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Indiana 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?

$5.89

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $5.89 for this service. The price depends on where it is billed: about $5.89 from a physician practice, and about $8.51 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 5 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$5.89$4.90 to $7.76
FacilityA hospital or hospital-owned outpatient department$8.51$4.90 to $8.51

How much rates vary

Facilitymedian $9 · 10th to 90th $4 to $10Professionalmedian $6 · 10th to 90th $4 to $9
$5$10facility $9professional $6

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
$8.51
Median
$8.51
Typical High
$8.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$6.31
Typical High
$8.51
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$9.55
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$5.25
Typical High
$10.00
CareSource
Setting
Facility
Modifier
Global
Typical Low
$9.77
Median
$12.88
Typical High
$14.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$13.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$8.13
United
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$3.80
Typical High
$10.00
United
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$4.68
Typical High
$7.08

Where Indiana 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.

Indiana· 45th of 51

$5.89

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.