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

Nebraska 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?

$2.95

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $2.95 for this service. The price depends on where it is billed: about $2.29 from a physician practice, and about $4.27 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.29$1.78 to $4.17
FacilityA hospital or hospital-owned outpatient department$4.27$3.09 to $5.89

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $79Professionalmedian $2 · 10th to 90th $1 to $5
$1$2$5$10$20$50facility $4professional $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
$3.80
Median
$3.80
Typical High
$3.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.15
Median
$3.80
Typical High
$5.01
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$4.27
Typical High
$4.27
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.27
Typical High
$7.94
Medica
Setting
Facility
Modifier
None
Typical Low
$3.09
Median
$4.17
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$1.26
Median
$1.86
Typical High
$2.95
Midlands
Setting
Professional
Modifier
None
Typical Low
$4.17
Median
$4.27
Typical High
$7.94
Midlands
Setting
Professional
Modifier
None
Typical Low
$5.25
Median
$7.94
Typical High
$10.47
United
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.78
Typical High
$2.40

Where Nebraska 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.

Nebraska· 19th of 51

$2.95

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.