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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Minnesota 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?

$9.77

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $9.77 for this service. The price depends on where it is billed: about $9.77 from a physician practice, and about $30.20 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$9.77$8.13 to $9.77
FacilityA hospital or hospital-owned outpatient department$30.20$10.96 to $43.65

How much rates vary

Facilitymedian $30 · 10th to 90th $6 to $81Professionalmedian $10 · 10th to 90th $6 to $12
$5$10$20$50$100facility $30professional $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
$6.31
Median
$6.31
Typical High
$6.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$6.31
Typical High
$8.32
BCBS
Setting
Facility
Modifier
Global
Typical Low
$9.12
Median
$11.48
Typical High
$16.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$9.77
Typical High
$9.77
Cigna
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$38.02
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$13.18
Typical High
$14.79
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$41.69
Typical High
$81.28
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$12.59
Medica
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$9.77
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$4.17
Typical High
$10.96
United
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$3.80
Typical High
$4.47
United
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$4.90
Typical High
$13.49

Where Minnesota 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.

Minnesota· 3rd of 51

$9.77

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.