go back

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

Vermont 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 $6 · 10th–90th $4$80%20%10th90th$6Professionalmedian $9 · 10th–90th $7$120%20%40%10th90th$9$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
$6.61
Median
$8.51
Typical High
$12.02
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
$6.46
Typical High
$7.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$10.00
Typical High
$12.30
United
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$4.47
Typical High
$5.75
United
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$7.76
Typical High
$25.70