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Ostomy Pouch, Drainable, High Output, Two-Piece, No Filter

Nationwide rates for HCPCS A4412

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), without filter, each

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $1$80%20%10th90th$3Professionalmedian $2 · 10th–90th $2$40%20%40%10th90th$2$0.0$0.5$10.0$200.0$5.0K$100.0K

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
$1.66
Median
$2.45
Typical High
$3.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.40
Typical High
$3.39
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$1.82
Typical High
$4.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$2.04
Typical High
$7.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.40
Typical High
$15.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$5.62
United
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.70
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.86
Typical High
$3.47