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Ostomy Pouch, Urinary, Extended Wear, Convexity, Faucet Tap

Pennsylvania rates for HCPCS A4430

Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (one piece), each

Rates data updated July 2026.

Facilitymedian $8 · 10th–90th $6$580%20%40%10th90th$8Professionalmedian $7 · 10th–90th $5$120%20%40%10th90th$7$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$5.89
Median
$5.89
Typical High
$9.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5.25
Median
$7.24
Typical High
$11.22
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$7.76
Typical High
$7.76
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$16.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$7.41
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$13.49
Typical High
$22.91
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$12.02
Typical High
$12.02
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$8.51
Typical High
$12.02
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$8.32
Typical High
$11.75
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$9.33
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$7.24
Typical High
$9.77
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$6.31
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$38.02
Typical High
$69.18
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$11.22
United
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$5.37
Typical High
$7.59
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$5.89
Typical High
$13.18