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

Vermont 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 $5 · 10th–90th $4$80%20%40%10th90th$5Professionalmedian $8 · 10th–90th $6$110%20%10th90th$8$5.0$10.0$20.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$8.13
Typical High
$11.22
BCBS
Setting
Professional
Modifier
Global
Typical Low
$9.55
Median
$9.55
Typical High
$9.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$7.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$7.41
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$9.33
Median
$9.33
Typical High
$11.75
United
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$4.17
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$7.41
Typical High
$23.99