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

Washington, DC 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 $9$90%50%$9Professionalmedian $9 · 10th–90th $6$90%50%10th$9$5.0$10.0$20.0

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
Facility
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$8.51
Typical High
$8.51
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$7.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$7.76
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$10.23
Median
$10.96
Typical High
$25.12
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$6.31
Typical High
$11.48