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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

North Dakota 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 $7 · 10th–90th $6$110%50%10th90th$7Professionalmedian $9 · 10th–90th $4$110%20%10th90th$9$2.0$5.0$10.0$20.0$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
Facility
Modifier
Global
Typical Low
$5.75
Median
$6.61
Typical High
$6.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.69
Median
$5.75
Typical High
$34.67
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$10.00
Typical High
$10.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$5.75
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$10.47
Typical High
$13.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$4.47
Median
$7.76
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$4.27
Typical High
$9.12
United
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$4.17
Typical High
$4.17
United
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$5.62
Typical High
$10.72