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Ostomy Pouch, Closed, One-Piece, with Filter

Montana rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Rates data updated July 2026.

How much does Ostomy Pouch, Closed, One-Piece, with Filter cost?

$3.31

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $3.31 for this service. The price depends on where it is billed: about $3.31 from a physician practice, and about $3.80 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$3.31$1.78 to $3.80
FacilityA hospital or hospital-owned outpatient department$3.80$2.95 to $4.07

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $5Professionalmedian $3 · 10th to 90th $1 to $17
$1$2$5$10$20$50facility $4professional $3

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
Professional
Modifier
Global
Typical Low
$1.05
Median
$3.09
Typical High
$16.60
BCBS
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
$4.07
Typical High
$4.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$4.07
Typical High
$4.07
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.80
Typical High
$7.41
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$3.80
Typical High
$7.41
Providence
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$3.09
Typical High
$4.57
Providence
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$4.07
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$1.29
Median
$1.48
Typical High
$1.51
United
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$1.62
Typical High
$2.19

Where Montana sits

The same service costs 2.1 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.

Montana· 10th of 51

$3.31

KS $3.98CO $1.91

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.