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Ostomy Pouch, Urinary, One-Piece, Standard Wear, Convex

Idaho rates for HCPCS A4392

Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (one piece), each

Rates data updated July 2026.

Facilitymedian $11 · 10th–90th $4$160%20%10th90th$11Professionalmedian $8 · 10th–90th $3$150%10%10th90th$8$2.0$5.0$10.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$7.76
Typical High
$15.49
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7.24
Median
$10.72
Typical High
$18.20
BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.88
Typical High
$12.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$7.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$8.13
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$10.96
Typical High
$15.49
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$10.96
Typical High
$11.75
Molina
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$30.20
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$12.88
Select Health
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$17.78
Select Health
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$10.96
Typical High
$12.88
United
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$4.47
Typical High
$7.24
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$4.79
Typical High
$6.61