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

Utah rates for HCPCS A4392

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

Rates data updated October 2026.

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

$5.89

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $5.89 for this service. The price depends on where it is billed: about $6.31 from a physician practice, and about $3.16 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$6.31$4.68 to $8.13
FacilityA hospital or hospital-owned outpatient department$3.16$3.16 to $6.92

How much rates vary

Facilitymedian $3 · 10th to 90th $3 to $7Professionalmedian $6 · 10th to 90th $3 to $10
$5$10$20$50facility $3professional $6

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$3.55
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.47
Median
$0.47
Typical High
$0.54
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.31
Median
$0.31
Typical High
$0.36
Cigna
Setting
Facility
Modifier
None
Typical Low
$6.92
Median
$6.92
Typical High
$7.41
Cigna
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$5.89
Typical High
$6.92
Molina
Setting
Professional
Modifier
None
Typical Low
$8.32
Median
$8.32
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Select Health
Setting
Facility
Modifier
None
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
Select Health
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$11.75
Typical High
$11.75
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$7.41
Median
$9.55
Typical High
$14.13
United
Setting
Professional
Modifier
None
Typical Low
$3.80
Median
$4.79
Typical High
$9.55

Where Utah sits

The same service costs 2.1 times more in Idaho 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.

Utah· 48th of 51

$5.89

ID $12.30CO $5.89

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.