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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Pennsylvania 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?

$6.03

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $6.03 for this service. The price depends on where it is billed: about $6.03 from a physician practice, and about $7.76 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 9 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$6.03$4.90 to $7.41
FacilityA hospital or hospital-owned outpatient department$7.76$4.79 to $33.11

How much rates vary

Facilitymedian $8 · 10th to 90th $5 to $52Professionalmedian $6 · 10th to 90th $4 to $10
$10$100$1K$10Kfacility $8professional $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
$4.79
Median
$4.79
Typical High
$7.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$6.03
Typical High
$9.33
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$9.77
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
$6.17
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$10.96
Typical High
$19.05
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$7.08
Typical High
$10.00
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$7.41
Typical High
$7.41
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$4.79
Typical High
$7.76
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$6.03
Typical High
$8.13
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$17.78
Median
$36.31
Typical High
$57.54
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$9.33
Typical High
$9.55
United
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$4.47
Typical High
$6.31
United
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$4.90
Typical High
$10.96

Where Pennsylvania 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.

Pennsylvania· 41st of 51

$6.03

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.