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

Minnesota rates for HCPCS A4393

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

Rates data updated October 2026.

How much does Ostomy Pouch, Urinary, One-Piece, Extended Wear, Convex cost?

$11.48

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $11.48 for this service. The price depends on where it is billed: about $11.48 from a physician practice, and about $13.18 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$11.48$8.91 to $14.79
FacilityA hospital or hospital-owned outpatient department$13.18$9.33 to $37.15

How much rates vary

Facilitymedian $13 · 10th to 90th $9 to $79Professionalmedian $11 · 10th to 90th $5 to $19
$5$10$20$50$100facility $13professional $11

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
$9.33
Median
$9.33
Typical High
$9.33
Aetna
Setting
Professional
Modifier
None
Typical Low
$9.12
Median
$9.33
Typical High
$9.33
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$11.75
Median
$15.49
Typical High
$21.88
BCBS Minnesota
Setting
Professional
Modifier
None
Typical Low
$10.23
Median
$12.88
Typical High
$12.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$7.59
Median
$43.65
Typical High
$109.65
Cigna
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$15.49
Typical High
$18.62
Health Partners
Setting
Facility
Modifier
None
Typical Low
$27.54
Median
$43.65
Typical High
$102.33
Health Partners
Setting
Professional
Modifier
None
Typical Low
$14.79
Median
$14.79
Typical High
$14.79
Medica
Setting
Facility
Modifier
None
Typical Low
$5.37
Median
$13.18
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$5.01
Median
$5.89
Typical High
$63.10
United
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$5.89
Typical High
$10.96
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
Facility
Modifier
55 · Aftercare only
Typical Low
$1.41
Median
$1.41
Typical High
$1.41
Aetna
Setting
Facility
Modifier
56 · Pre-op care only
Typical Low
$0.93
Median
$0.93
Typical High
$0.93
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$1.35
Median
$1.41
Typical High
$1.41
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.91
Median
$0.93
Typical High
$0.93

Where Minnesota sits

The same service costs 2.1 times more in Idaho than in Connecticut. 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.

Minnesota· 10th of 51

$11.48

ID $13.49CT $6.46

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.