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

Utah 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?

$5.50

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $5.50 for this service. The price depends on where it is billed: about $5.50 from a physician practice, and about $2.09 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 7 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$5.50$3.24 to $7.94
FacilityA hospital or hospital-owned outpatient department$2.09$2.09 to $2.57

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $5Professionalmedian $5 · 10th to 90th $2 to $33
$2$5$10$20facility $2professional $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
$2.09
Median
$2.09
Typical High
$2.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.09
Median
$5.01
Typical High
$33.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$4.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$3.89
Typical High
$5.50
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$5.62
Typical High
$7.59
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$5.50
Typical High
$8.71
Select Health
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$7.76
Typical High
$7.76
Select Health
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$7.76
Typical High
$7.76
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$7.76
Typical High
$9.33
United
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$3.02
Typical High
$3.47
United
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$3.24
Typical High
$5.75

Where Utah 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.

Utah· 21st of 51

$5.50

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.