go back

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

Texas 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 $6$310%10%20%10th90th$10Professionalmedian $7 · 10th–90th $5$100%20%10th90th$7$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$2.69
Median
$7.41
Typical High
$8.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.41
Typical High
$10.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$7.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.91
Median
$11.48
Typical High
$31.62
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$6.17
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$9.33
Typical High
$14.13
Christus
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$79.43
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
$6.92
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$85.11
Typical High
$85.11
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$9.55
Typical High
$16.22
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$6.92
Median
$10.00
Typical High
$11.75
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$81.28
Providence
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$9.12
Typical High
$16.22
Providence
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$7.41
United
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$5.25
Typical High
$11.75
United
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$5.25
Typical High
$6.92
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$11.75
Typical High
$15.85