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

Montana rates for HCPCS A4392

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

Rates data updated July 2026.

How much does Ostomy Pouch, Urinary, One-Piece, Standard Wear, Convex cost?

$9.77

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $9.77 for this service. The price depends on where it is billed: about $9.77 from a physician practice, and about $11.22 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 6 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$9.77$5.37 to $11.22
FacilityA hospital or hospital-owned outpatient department$11.22$8.71 to $12.02

How much rates vary

Facilitymedian $11 · 10th to 90th $7 to $14Professionalmedian $10 · 10th to 90th $4 to $50
$5$10$20$50facility $11professional $10

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
Professional
Modifier
Global
Typical Low
$3.16
Median
$9.12
Typical High
$50.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$11.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$12.02
Typical High
$12.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$12.02
Typical High
$12.02
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$11.22
Typical High
$21.88
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$11.22
Typical High
$21.88
Providence
Setting
Facility
Modifier
Global
Typical Low
$5.62
Median
$9.12
Typical High
$13.80
Providence
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.02
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$4.37
Typical High
$4.47
United
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.79
Typical High
$6.61

Where Montana sits

The same service costs 2.0 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.

Montana· 12th of 51

$9.77

HI $11.75CO $5.75

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.