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

Hawaii 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.

How much does Ostomy Pouch, Drainable, High Output, Two-Piece, No Filter cost?

$3.89

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $3.89 for this service. Most negotiated rates run $2.14 to $3.89.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $4 · 10th to 90th $2 to $4
$2$5facility $1professional $4

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
Professional
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$2.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.82
Typical High
$3.02
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$3.55
Typical High
$4.79
HMSA
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$4.07
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$3.89
Typical High
$5.37
United
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.26
Typical High
$1.48
United
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$2.69
Typical High
$4.68

Where Hawaii sits

The same service costs 2.3 times more in Kansas than in Colorado. 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.

Hawaii· 2nd of 51

$3.89

KS $4.37CO $1.86

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.