Urinary ostomy pouch, rubber faceplate, each

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Urinary rubber pouch w/o fp

Payers reporting HCPCS A4383

Payer pricing summary

Low

$10

Average

$46

Median

$41

High

$136

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	299	$40	$61	$64	105%	—	$18 – $309
2	UnitedHealthcare fee schedule · outpatient · +9 other terms	288	$40	$39	$5	13%	—	$17 – $46
3	Aetna fee schedule · outpatient · +7 other terms	265	$41	$44	$21	48%	—	$18 – $243
4	WellCare fee schedule · outpatient · +4 other terms	184	$41	$43	$7	16%	—	$39 – $78
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	181	$41	$49	$25	51%	—	$0 – $180
6	Devoted fee schedule · outpatient · +2 other terms	163	$40	$40	$1	2%	—	$39 – $43
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$41	$41	$1	3%	—	$40 – $43
8	Molina fee schedule · outpatient · +4 other terms	96	$54	$55	$21	39%	—	$33 – $105
9	Cigna fee schedule · outpatient · +5 other terms	77	$41	$44	$11	24%	—	$39 – $100
10	Anthem fee schedule · outpatient · +6 other terms	73	$39	$40	$3	8%	—	$39 – $65
11	Superior Healthplan fee schedule · outpatient	40	$42	$42	$0	0%	—	$39 – $42
12	Kaiser fee schedule · outpatient · +4 other terms	39	$39	$40	$1	2%	—	$39 – $41
13	Clover fee schedule · outpatient · +1 other terms	37	$40	$41	$1	3%	—	$39 – $42
14	Bcbs Tx fee schedule · outpatient	31	$37	$38	$11	29%	—	$28 – $138
15	Optum fee schedule · outpatient · +1 other terms	25	$40	$47	$19	42%	—	$39 – $100
16	Oscar fee schedule · outpatient · +2 other terms	24	$39	$41	$1	3%	—	$39 – $42
17	Caresource facility · case rate · outpatient · +4 other terms	20	$37	$44	$17	38%	—	$23 – $80
18	Medicare fee schedule · outpatient	18	$39	$39	$0	1%	—	$39 – $39
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$48	$48	$1	2%	—	$46 – $48
20	Wellmark fee schedule · both · +1 other terms	13	$35	$35	$1	3%	—	$29 – $35
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$19	$27	$10	37%	—	$19 – $39
22	Ambetter case rate · outpatient · +5 other terms	12	$57	$59	$3	4%	—	$57 – $63
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$34	$22	$19	85%	—	$0 – $43
24	Bcbs Nj fee schedule · outpatient	12	$39	$85	$58	68%	—	$39 – $174
25	Highmark fee schedule · outpatient · +4 other terms	10	$41	$43	$15	36%	—	$18 – $94

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