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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 October 2026.

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

$10.00

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $10.00 for this service. The price depends on where it is billed: about $10.00 from a physician practice, and about $13.80 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$10.00$7.94 to $13.18
FacilityA hospital or hospital-owned outpatient department$13.80$8.71 to $13.80

How much rates vary

Facilitymedian $14 · 10th to 90th $8 to $22Professionalmedian $10 · 10th to 90th $5 to $16
$5$10$20$50facility $14professional $10

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
Aetna
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$8.13
Typical High
$10.47
Cigna
Setting
Facility
Modifier
None
Typical Low
$7.08
Median
$7.08
Typical High
$13.49
Cigna
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$13.80
Typical High
$17.38
Medica
Setting
Facility
Modifier
None
Typical Low
$8.13
Median
$13.80
Typical High
$22.39
Medica
Setting
Professional
Modifier
None
Typical Low
$4.79
Median
$6.76
Typical High
$58.88
Midlands
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$13.18
Typical High
$13.49
Midlands
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$10.96
Typical High
$21.38
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$10.23
Median
$12.02
Typical High
$13.80
United
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$5.62
Typical High
$8.91
Wellmark
Setting
Professional
Modifier
None
Typical Low
$9.77
Median
$9.77
Typical High
$9.77

Where South Dakota sits

The same service costs 2.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 14th of 51

$10.00

HI $12.59DE $6.03

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.