go back

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

Illinois 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 October 2026.

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

$2.40

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $2.40 for this service. The price depends on where it is billed: about $2.29 from a physician practice, and about $8.71 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$2.29$1.86 to $2.88
FacilityA hospital or hospital-owned outpatient department$8.71$3.89 to $18.62

How much rates vary

Facilitymedian $9 · 10th to 90th $2 to $32Professionalmedian $2 · 10th to 90th $2 to $5
$2$5$10$20$50facility $9professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1.78
Median
$2.14
Typical High
$3.89
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.78
Median
$2.14
Typical High
$3.24
Ambetter
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$6.61
Median
$10.72
Typical High
$33.11
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$1.82
Median
$2.88
Typical High
$2.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$2.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.95
Median
$1.95
Typical High
$2.69
Hally Health
Setting
Professional
Modifier
None
Typical Low
$3.39
Median
$5.25
Typical High
$11.48
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$4.90
Median
$4.90
Typical High
$4.90
Molina
Setting
Professional
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
United
Setting
Professional
Modifier
None
Typical Low
$1.48
Median
$1.86
Typical High
$4.57

Where Illinois sits

The same service costs 2.2 times more in Kansas than in Alabama. 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.

Illinois· 27th of 51

$2.40

KS $4.37AL $1.95

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.