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

Minnesota 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 $11 · 10th–90th $2$320%10%10th90th$11Professionalmedian $4 · 10th–90th $2$40%50%10th90th$4$0.1$0.2$1.0$5.0$20.0$100.0

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
$2.40
Median
$2.40
Typical High
$2.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$2.40
Typical High
$3.16
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.55
Median
$4.47
Typical High
$6.46
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$3.80
Typical High
$3.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.71
Median
$14.79
Typical High
$39.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$5.13
Typical High
$5.75
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$16.22
Typical High
$31.62
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$4.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$1.62
Median
$3.80
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.58
Typical High
$4.17
United
Setting
Facility
Modifier
Global
Typical Low
$1.23
Median
$1.45
Typical High
$1.74
United
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.86
Typical High
$5.25