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

Rhode Island 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 $21 · 10th–90th $6$260%10%20%10th90th$21Professionalmedian $6 · 10th–90th $5$90%10%20%10th90th$6$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$5.01
Typical High
$8.71
BCBS
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$22.91
Typical High
$26.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$6.03
Typical High
$10.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$6.92
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$5.89
United
Setting
Facility
Modifier
Global
Typical Low
$5.25
Median
$5.25
Typical High
$6.03
United
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$6.61
Typical High
$9.55