go back

Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Maine 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 $5 · 10th–90th $4$70%20%10th90th$5Professionalmedian $6 · 10th–90th $4$80%20%10th90th$6$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$4.79
Typical High
$8.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$6.46
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$7.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$6.17
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$9.55
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$5.25
Typical High
$6.92
United
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$3.55
Typical High
$4.90
United
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$7.94
Typical High
$7.94