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

Indiana 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$40%20%10th90th$3Professionalmedian $2 · 10th–90th $2$30%10%20%10th90th$2$1.0$2.0$5.0$10.0

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
$3.24
Median
$3.24
Typical High
$3.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.40
Typical High
$3.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$1.91
Typical High
$3.63
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$1.95
Typical High
$3.39
CareSource
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$4.90
Typical High
$5.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$8.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$3.09
United
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.48
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.82
Typical High
$2.69