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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Montana rates for HCPCS A4428

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

Rates data updated October 2026.

How much does Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap cost?

$9.55

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $9.55 for this service. The price depends on where it is billed: about $9.55 from a physician practice, and about $10.00 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$9.55$7.24 to $9.55
FacilityA hospital or hospital-owned outpatient department$10.00$9.33 to $525

How much rates vary

Facilitymedian $10 · 10th to 90th $7 to $537Professionalmedian $10 · 10th to 90th $4 to $79
$5$10$20$50$100$200$500facility $10professional $10

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$7.76
Typical High
$12.30
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$8.91
Median
$8.91
Typical High
$8.91
Cigna
Setting
Facility
Modifier
None
Typical Low
$8.51
Median
$9.55
Typical High
$9.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$7.76
Median
$9.55
Typical High
$9.55
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$6.92
Median
$11.48
Typical High
$549.54
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$9.33
Median
$10.23
Typical High
$562.34
Providence
Setting
Facility
Modifier
None
Typical Low
$5.50
Median
$9.55
Typical High
$9.55
Providence
Setting
Professional
Modifier
None
Typical Low
$7.24
Median
$9.55
Typical High
$79.43
United
Setting
Professional
Modifier
None
Typical Low
$3.63
Median
$3.89
Typical High
$6.46

Where Montana sits

The same service costs 2.3 times more in Kansas than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 4th of 51

$9.55

KS $10.72AL $4.68

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.