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

Nebraska 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 $12 · 10th–90th $5$790%10%20%10th90th$12Professionalmedian $8 · 10th–90th $3$100%20%40%10th90th$8$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
$9.55
Median
$9.55
Typical High
$9.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$7.59
Typical High
$9.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.96
Typical High
$11.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$7.59
Typical High
$12.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$13.18
Typical High
$23.99
Medica
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$16.22
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.75
Typical High
$11.48
Midlands
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$30.90
Midlands
Setting
Facility
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
Midlands
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$28.84
Typical High
$30.90
United
Setting
Facility
Modifier
Global
Typical Low
$4.07
Median
$6.92
Typical High
$11.75
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.37
Typical High
$8.91