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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Virginia 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?

$6.17

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $6.17 for this service. The price depends on where it is billed: about $6.17 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 8 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$6.17$4.90 to $7.08
FacilityA hospital or hospital-owned outpatient department$7.76$6.46 to $10.23

How much rates vary

Facilitymedian $8 · 10th to 90th $6 to $17Professionalmedian $6 · 10th to 90th $5 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
$6.17
Median
$6.17
Typical High
$6.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$6.17
Typical High
$7.41
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$10.23
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$6.61
Typical High
$6.92
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$6.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$10.00
Typical High
$14.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$7.08
Typical High
$10.72
Medcost
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$7.08
Typical High
$12.02
Medcost
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$6.17
Typical High
$6.61
Sentara
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$8.91
Typical High
$34.67
Sentara
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$8.91
Typical High
$28.84
United
Setting
Facility
Modifier
Global
Typical Low
$2.82
Median
$3.80
Typical High
$5.01
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$4.90
Typical High
$7.76

Where Virginia 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.

Virginia· 36th of 51

$6.17

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.