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

South Dakota 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.

How much does Ostomy Pouch, Urinary, Extended Wear, Convexity, Faucet Tap cost?

$11.22

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $11.22 for this service. The price depends on where it is billed: about $11.22 from a physician practice, and about $12.59 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$11.22$8.13 to $13.80
FacilityA hospital or hospital-owned outpatient department$12.59$8.71 to $13.80

How much rates vary

Facilitymedian $13 · 10th to 90th $7 to $16Professionalmedian $11 · 10th to 90th $8 to $17
$5.0$10.0$20.0$50.0facility $13professional $11

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$8.13
Typical High
$16.22
Avera
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$12.59
Typical High
$13.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$13.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$17.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$8.13
Median
$12.88
Typical High
$22.39
Medica
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$7.59
Typical High
$58.88
Midlands
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$13.18
Typical High
$13.18
Midlands
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$13.49
Typical High
$13.49
Midlands
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$10.96
Typical High
$21.38
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$12.02
Typical High
$15.85
United
Setting
Facility
Modifier
Global
Typical Low
$4.68
Median
$5.62
Typical High
$8.32
United
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$7.94
Typical High
$13.80
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$9.77
Typical High
$9.77

Where South Dakota sits

The same service costs 2.0 times more in Minnesota than in Colorado. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $11.22 · 5th of 51
MN $12.02CO $5.89

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.