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Ostomy Pouch, Closed, One-Piece, Convex, with Filter

Hawaii rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Rates data updated July 2026.

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

$5.37

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $5.37 for this service. Most negotiated rates run $2.95 to $5.37.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $4Professionalmedian $5 · 10th to 90th $3 to $6
$2.0$5.0$10.0facility $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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.63
Typical High
$4.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$4.90
Typical High
$6.61
HMSA
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$5.62
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$5.37
Typical High
$7.41
United
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$1.74
Typical High
$2.04
United
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$3.72
Typical High
$6.46

Where Hawaii sits

The same service costs 2.1 times more in Hawaii than in Colorado. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Hawaii $5.37 · 1st of 51
HI $5.37CO $2.57

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.