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

New Jersey 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 $2 · 10th–90th $1$40%50%10th90th$2Professionalmedian $2 · 10th–90th $1$30%10%10th90th$2$0.0$0.1$0.5$2.0$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
$1.86
Median
$1.86
Typical High
$1.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.86
Typical High
$3.31
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
$2.29
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$4.27
Typical High
$5.25
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
United
Setting
Facility
Modifier
Global
Typical Low
$1.26
Median
$1.78
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.14
Typical High
$3.80