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Ostomy Pouch, Drainable, High Output, Two-Piece, with Filter

New Hampshire rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Rates data updated July 2026.

How much does Ostomy Pouch, Drainable, High Output, Two-Piece, with Filter cost?

$4.57

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $4.57 for this service. The price depends on where it is billed: about $4.68 from a physician practice, and about $4.07 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 6 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$4.68$3.89 to $6.76
FacilityA hospital or hospital-owned outpatient department$4.07$4.07 to $4.79

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $5Professionalmedian $5 · 10th to 90th $3 to $7
$2$5$10facility $4professional $5

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
$4.07
Median
$4.07
Typical High
$4.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$4.07
Typical High
$4.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$4.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$6.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$5.50
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$12.59
United
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.95
Typical High
$3.16
United
Setting
Professional
Modifier
Global
Typical Low
$2.69
Median
$4.37
Typical High
$6.76
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$10.23
Typical High
$17.38

Where New Hampshire sits

The same service costs 2.2 times more in Hawaii 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.

New Hampshire· 43rd of 51

$4.57

HI $7.76CO $3.47

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.