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Ostomy Pouch, Urinary, Extended Wear Barrier, Faucet Tap

Vermont 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 $4 · 10th–90th $3$60%20%10th90th$4Professionalmedian $6 · 10th–90th $5$90%20%40%10th90th$6$5.0$10.0$20.0

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
$4.79
Median
$6.17
Typical High
$8.71
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
$5.62
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$8.91
United
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$3.24
Typical High
$4.17
United
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$5.62
Typical High
$18.20