go back

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

Texas 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 $4 · 10th–90th $2$100%20%10th90th$4Professionalmedian $2 · 10th–90th $2$30%20%10th90th$2$0.0$0.2$2.0$20.0$200.0$2.0K

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
$1.91
Median
$2.45
Typical High
$2.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.45
Typical High
$3.31
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.80
Typical High
$10.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$1.82
Typical High
$2.04
Christus
Setting
Facility
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$79.43
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
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$28.18
Typical High
$28.18
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$1.82
Median
$3.55
Typical High
$5.62
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$3.31
Typical High
$3.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$2.82
Typical High
$81.28
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.82
Median
$3.24
Typical High
$5.62
Providence
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$1.95
Typical High
$2.29
United
Setting
Facility
Modifier
Global
Typical Low
$1.26
Median
$1.74
Typical High
$3.89
United
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.74
Typical High
$2.29
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1.91
Median
$3.89
Typical High
$5.25