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

Wyoming 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 $5$120%20%10th90th$6Professionalmedian $11 · 10th–90th $5$120%20%10th90th$11$5.0$10.0

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
$5.37
Median
$5.37
Typical High
$10.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$12.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$12.30
Typical High
$12.30
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
$7.59
United
Setting
Facility
Modifier
Global
Typical Low
$4.90
Median
$5.37
Typical High
$5.89
United
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$5.37
Typical High
$7.24