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

Pennsylvania 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.

How much does Ostomy Pouch, Drainable, High Output, Two-Piece, No Filter cost?

$2.29

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $2.29 for this service. The price depends on where it is billed: about $2.29 from a physician practice, and about $2.29 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.29$1.86 to $2.88
FacilityA hospital or hospital-owned outpatient department$2.29$1.86 to $3.89

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $19Professionalmedian $2 · 10th to 90th $2 to $4
$1$10$100$1K$10Kfacility $2professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$2.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$2.29
Typical High
$3.55
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$3.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$2.29
Typical High
$8.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$2.34
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$5.01
Typical High
$7.41
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$3.89
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.69
Typical High
$3.89
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$2.95
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$2.29
Typical High
$3.16
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$3.47
Typical High
$3.47
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$3.63
Median
$13.49
Typical High
$21.88
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$2.69
Median
$3.63
Typical High
$3.63
United
Setting
Facility
Modifier
Global
Typical Low
$1.26
Median
$1.74
Typical High
$2.40
United
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.86
Typical High
$3.89

Where Pennsylvania sits

The same service costs 2.3 times more in Kansas than in Colorado. 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.

Pennsylvania· 43rd of 51

$2.29

KS $4.37CO $1.86

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.