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

Nebraska 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 $5$790%10%20%10th90th$13Professionalmedian $8 · 10th–90th $4$110%20%40%10th90th$8$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
$10.47
Median
$10.47
Typical High
$10.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$8.32
Typical High
$10.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$12.30
Typical High
$12.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.59
Median
$7.94
Typical High
$14.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$14.79
Typical High
$26.30
Medica
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$17.78
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$6.31
Typical High
$12.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$33.88
Midlands
Setting
Facility
Modifier
Global
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$17.38
Median
$31.62
Typical High
$33.88
United
Setting
Facility
Modifier
Global
Typical Low
$4.57
Median
$7.59
Typical High
$12.88
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$6.03
Typical High
$10.00