go back

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

Minnesota 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 $34 · 10th–90th $7$930%10%10th90th$34Professionalmedian $11 · 10th–90th $7$130%20%40%10th90th$11$0.1$0.5$2.0$10.0$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
$7.24
Median
$7.24
Typical High
$7.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$7.24
Typical High
$9.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$13.49
Typical High
$19.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$11.48
Typical High
$11.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$42.66
Typical High
$117.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$14.79
Typical High
$16.60
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$46.77
Typical High
$93.33
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$13.18
Typical High
$14.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$11.48
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$4.79
Typical High
$12.59
United
Setting
Facility
Modifier
Global
Typical Low
$3.72
Median
$4.37
Typical High
$5.25
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.75
Typical High
$15.85