go back

Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Arizona rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Rates data updated July 2026.

Facilitymedian $9 · 10th–90th $3$190%10%10th90th$9Professionalmedian $5 · 10th–90th $3$100%10%10th90th$5$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
Professional
Modifier
Global
Typical Low
$2.69
Median
$5.50
Typical High
$7.94
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$7.41
Typical High
$7.41
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$10.23
Typical High
$19.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$9.55
Typical High
$19.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$5.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$7.08
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$3.89
Typical High
$45.71
United
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.63
Typical High
$9.33
United
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$3.89
Typical High
$5.75