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

Missouri 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 $2$80%20%10th90th$3Professionalmedian $2 · 10th–90th $2$50%20%10th90th$2$0.5$1.0$2.0$5.0$10.0$20.0$50.0

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
$1.62
Median
$3.80
Typical High
$3.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.45
Typical High
$16.60
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$2.00
Typical High
$3.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$3.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$3.39
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$2.29
Medica
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$3.24
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.86
Typical High
$18.62
United
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$2.40
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.86
Typical High
$2.88