go back

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

Illinois 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?

$3.55

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $3.55 for this service. The price depends on where it is billed: about $3.47 from a physician practice, and about $5.37 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$3.47$2.95 to $4.37
FacilityA hospital or hospital-owned outpatient department$5.37$2.95 to $13.18

How much rates vary

Facilitymedian $5 · 10th to 90th $3 to $27Professionalmedian $3 · 10th to 90th $2 to $5
$0.1$1.0$10.0$100.0facility $5professional $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
Facility
Modifier
Global
Typical Low
$2.95
Median
$2.95
Typical High
$5.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$3.24
Typical High
$5.37
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$3.47
Median
$3.47
Typical High
$3.47
BCBS
Setting
Facility
Modifier
Global
Typical Low
$7.76
Median
$13.49
Typical High
$45.71
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$3.98
Typical High
$3.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$5.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$5.75
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.24
Typical High
$10.96
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$6.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$2.45
Typical High
$2.45
United
Setting
Facility
Modifier
Global
Typical Low
$1.66
Median
$5.37
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.57
Typical High
$4.57

Where Illinois 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.

Illinois $3.55 · 26th 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.