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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Montana 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?

$8.51

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $8.51 for this service. The price depends on where it is billed: about $8.51 from a physician practice, and about $9.55 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$8.51$4.57 to $9.55
FacilityA hospital or hospital-owned outpatient department$9.55$7.59 to $10.47

How much rates vary

Facilitymedian $10 · 10th to 90th $6 to $12Professionalmedian $9 · 10th to 90th $3 to $43
$5$10$20$50facility $10professional $9

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
Professional
Modifier
Global
Typical Low
$2.69
Median
$7.94
Typical High
$42.66
BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$9.55
Typical High
$9.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$10.47
Typical High
$10.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$10.47
Typical High
$10.47
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$9.55
Typical High
$18.62
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$9.55
Typical High
$18.62
Providence
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$9.12
Typical High
$11.75
Providence
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$10.47
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$3.80
Typical High
$3.80
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$4.17
Typical High
$5.62

Where Montana 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.

Montana· 12th of 51

$8.51

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.