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

Virginia 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?

$7.08

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $7.08 for this service. The price depends on where it is billed: about $7.08 from a physician practice, and about $7.76 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$7.08$5.89 to $8.13
FacilityA hospital or hospital-owned outpatient department$7.76$6.92 to $9.77

How much rates vary

Facilitymedian $8 · 10th to 90th $6 to $19Professionalmedian $7 · 10th to 90th $6 to $11
$10$100$1K$10Kfacility $8professional $7

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$7.08
Median
$7.08
Typical High
$7.76
Aetna
Setting
Professional
Modifier
None
Typical Low
$7.08
Median
$7.08
Typical High
$7.76
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$5.89
Typical High
$8.13
CareFirst
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$7.76
Typical High
$7.94
Cigna
Setting
Facility
Modifier
None
Typical Low
$6.92
Median
$6.92
Typical High
$7.59
Cigna
Setting
Professional
Modifier
None
Typical Low
$5.89
Median
$5.89
Typical High
$6.92
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$11.75
Typical High
$15.14
Medcost
Setting
Professional
Modifier
None
Typical Low
$7.41
Median
$8.13
Typical High
$11.48
Medcost
Setting
Facility
Modifier
None
Typical Low
$3.47
Median
$6.31
Typical High
$8.13
Medcost
Setting
Professional
Modifier
None
Typical Low
$6.03
Median
$6.31
Typical High
$7.59
Sentara
Setting
Facility
Modifier
None
Typical Low
$5.75
Median
$8.71
Typical High
$33.88
Sentara
Setting
Professional
Modifier
None
Typical Low
$7.59
Median
$8.91
Typical High
$17.78
United
Setting
Professional
Modifier
None
Typical Low
$4.79
Median
$5.75
Typical High
$8.51
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$1.07
Median
$1.07
Typical High
$1.15
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.71
Median
$0.71
Typical High
$0.78
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$0.59
Median
$0.59
Typical High
$0.81
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4.27
Median
$4.47
Typical High
$4.68

Where Virginia 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.

Virginia· 29th of 51

$7.08

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.