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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Rhode Island 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 $17 · 10th–90th $5$210%10%20%10th90th$17Professionalmedian $5 · 10th–90th $4$70%10%20%10th90th$5$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.98
Typical High
$6.92
BCBS
Setting
Facility
Modifier
Global
Typical Low
$13.18
Median
$18.20
Typical High
$21.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$4.79
Typical High
$7.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$4.68
United
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$4.17
Typical High
$4.79
United
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$5.25
Typical High
$7.59