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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

South Carolina 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 $4$120%20%10th90th$7Professionalmedian $7 · 10th–90th $4$80%20%10th90th$7$0.1$0.5$2.0$10.0$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
$7.24
Median
$7.24
Typical High
$7.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$7.24
Typical High
$7.94
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$8.32
Typical High
$9.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$9.33
Typical High
$11.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.75
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$12.59
Medcost
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$5.89
Medcost
Setting
Facility
Modifier
Global
Typical Low
$5.62
Median
$8.32
Typical High
$14.79
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$3.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$6.17
Typical High
$6.17
United
Setting
Facility
Modifier
Global
Typical Low
$2.88
Median
$3.55
Typical High
$9.33
United
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$4.37
Typical High
$5.89