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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Idaho 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 $4$130%20%10th90th$9Professionalmedian $7 · 10th–90th $3$120%10%10th90th$7$5.0$10.0$20.0

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
$6.17
Typical High
$12.30
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$8.51
Typical High
$14.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$10.23
Typical High
$10.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$6.46
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$8.91
Typical High
$12.30
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$8.91
Typical High
$9.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$9.77
Typical High
$30.20
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$6.46
Typical High
$10.23
Select Health
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$14.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$8.91
Typical High
$10.23
United
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$3.55
Typical High
$5.75
United
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$3.89
Typical High
$4.90