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

Nationwide rates for HCPCS A4393

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

Rates data updated July 2026.

Facilitymedian $9 · 10th–90th $5$280%20%10th90th$9Professionalmedian $8 · 10th–90th $5$130%20%40%10th90th$8$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
$5.50
Median
$8.13
Typical High
$12.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$7.94
Typical High
$11.22
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$6.03
Typical High
$15.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$7.08
Typical High
$14.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$7.94
Typical High
$48.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$18.20
United
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$5.75
Typical High
$12.88
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$6.31
Typical High
$11.48