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

Massachusetts 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?

$4.57

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $4.57 for this service. The price depends on where it is billed: about $4.57 from a physician practice, and about $4.37 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 8 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$4.57$2.51 to $4.57
FacilityA hospital or hospital-owned outpatient department$4.37$2.29 to $13.80

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $79Professionalmedian $5 · 10th to 90th $2 to $7
$10.0$100.0$1.0K$10.0Kfacility $4professional $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
$2.29
Median
$2.29
Typical High
$2.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.75
Typical High
$8.91
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.13
Typical High
$79.43
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$4.27
Typical High
$6.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$4.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$3.72
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$6.92
Health New England
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$2.95
Typical High
$2.95
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.13
Typical High
$79.43
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$4.27
Typical High
$6.31
United
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$2.34
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$4.37
Typical High
$4.68

Where Massachusetts 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.

Massachusetts $4.57 · 8th 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.