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

Oklahoma 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$30%50%10th$3Professionalmedian $2 · 10th–90th $1$30%20%10th90th$2$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
$2.24
Median
$2.24
Typical High
$2.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$2.24
Typical High
$2.24
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$3.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$3.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.62
Median
$2.29
Typical High
$2.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$2.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$2.63
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.82
Typical High
$5.50
United
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$1.78
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.58
Typical High
$2.29