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

Indiana 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 $10 · 10th–90th $4$110%20%10th90th$10Professionalmedian $7 · 10th–90th $5$100%10%20%10th90th$7$5.0$10.0$20.0$50.0

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
Facility
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$9.77
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.24
Typical High
$10.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$10.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$6.03
Typical High
$11.48
CareSource
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$14.79
Typical High
$16.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$15.85
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$9.33
United
Setting
Facility
Modifier
Global
Typical Low
$3.72
Median
$4.47
Typical High
$11.75
United
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$5.50
Typical High
$8.13