go back

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

Michigan 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 $13 · 10th–90th $6$580%20%10th90th$13Professionalmedian $9 · 10th–90th $5$130%20%10th90th$9$0.1$0.5$2.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$9.55
Median
$9.55
Typical High
$9.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$7.76
Typical High
$10.72
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$12.88
Median
$12.88
Typical High
$12.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$16.60
Median
$38.02
Typical High
$72.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$13.18
CareSource
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$7.59
Typical High
$7.94
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$7.94
Typical High
$7.94
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$7.94
Median
$8.91
Typical High
$26.30
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$10.23
Typical High
$15.49
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$10.47
United
Setting
Facility
Modifier
Global
Typical Low
$3.47
Median
$4.90
Typical High
$8.13
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$5.89
Typical High
$9.12