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

Indiana 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?

$3.09

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $3.09 for this service. The price depends on where it is billed: about $3.09 from a physician practice, and about $4.47 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 5 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$3.09$2.57 to $4.17
FacilityA hospital or hospital-owned outpatient department$4.47$2.57 to $4.47

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $5Professionalmedian $3 · 10th to 90th $2 to $5
$2.0$5.0$10.0$20.0facility $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
Facility
Modifier
Global
Typical Low
$4.47
Median
$4.47
Typical High
$4.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$3.31
Typical High
$4.47
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$5.01
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.75
Typical High
$5.25
CareSource
Setting
Facility
Modifier
Global
Typical Low
$5.25
Median
$6.76
Typical High
$7.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$7.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$5.75
United
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$2.04
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.45
Typical High
$3.72

Where Indiana 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.

Indiana $3.09 · 45th 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.