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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Oklahoma 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?

$5.50

Typical negotiated rate. In Oklahoma, October 2026.

Insurers have agreed to pay about $5.50 for this service. The price depends on where it is billed: about $5.25 from a physician practice, and about $7.94 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5.25$4.07 to $7.94
FacilityA hospital or hospital-owned outpatient department$7.94$5.50 to $7.94

How much rates vary

Facilitymedian $8 · 10th to 90th $5 to $11Professionalmedian $5 · 10th to 90th $3 to $13
$5$10$20$50facility $8professional $5

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
Facility
Modifier
None
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
Aetna
Setting
Professional
Modifier
None
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
BCBS
Setting
Facility
Modifier
None
Typical Low
$7.94
Median
$7.94
Typical High
$7.94
BCBS
Setting
Professional
Modifier
None
Typical Low
$7.94
Median
$7.94
Typical High
$7.94
Cigna
Setting
Facility
Modifier
None
Typical Low
$3.89
Median
$5.50
Typical High
$6.17
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.68
Median
$4.68
Typical High
$4.68
Medica
Setting
Facility
Modifier
None
Typical Low
$5.50
Median
$5.62
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$5.50
Typical High
$45.71
United
Setting
Professional
Modifier
None
Typical Low
$2.57
Median
$3.80
Typical High
$5.50
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$2.69
Median
$2.69
Typical High
$2.69
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$1.07
Median
$1.07
Typical High
$1.10
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.79
Median
$0.79
Typical High
$0.81
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.54
Median
$0.54
Typical High
$0.54

Where Oklahoma sits

The same service costs 2.3 times more in Kansas than in New Jersey. 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.

Oklahoma· 34th of 51

$5.50

KS $10.72NJ $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.