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

Rhode Island 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 $23 · 10th–90th $7$300%10%20%10th90th$23Professionalmedian $7 · 10th–90th $5$100%20%10th90th$7$5.0$10.0$20.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$5.50
Typical High
$9.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$18.62
Median
$25.12
Typical High
$29.51
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.62
Median
$6.61
Typical High
$11.22
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
$6.46
United
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$6.61
United
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$7.24
Typical High
$10.47