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

Vermont 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 $5 · 10th–90th $4$80%20%10th90th$5Professionalmedian $8 · 10th–90th $6$110%20%40%10th90th$8$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
$6.03
Median
$7.76
Typical High
$10.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$7.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$7.08
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$8.91
Median
$8.91
Typical High
$11.22
United
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$3.98
Typical High
$5.25
United
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$7.08
Typical High
$22.91