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

North Carolina 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$70%20%10th90th$3Professionalmedian $3 · 10th–90th $2$30%20%10th90th$3$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$3.31
Median
$3.31
Typical High
$3.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$3.31
Typical High
$3.31
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$3.72
Typical High
$7.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$2.88
Typical High
$3.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$2.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$2.69
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$1.91
Typical High
$2.57
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1.62
Median
$3.31
Typical High
$5.50
United
Setting
Facility
Modifier
Global
Typical Low
$1.26
Median
$2.45
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.82
Typical High
$2.63
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$28.18