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

Maryland rates for HCPCS A4417

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

Rates data updated October 2026.

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

$3.16

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $3.16 for this service. Most negotiated rates run $2.57 to $3.55.

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.

How much rates vary

Facilitymedian $3 · 10th to 90th $3 to $4Professionalmedian $3 · 10th to 90th $3 to $4
$2$5facility $3professional $3

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$2.51
Median
$3.24
Typical High
$3.55
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$1.26
Median
$1.66
Typical High
$1.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.51
Median
$0.66
Typical High
$0.71
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.38
Median
$0.50
Typical High
$0.52
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.25
Median
$0.33
Typical High
$0.35
CareFirst
Setting
Professional
Modifier
None
Typical Low
$3.55
Median
$3.55
Typical High
$3.63
Cigna
Setting
Facility
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$3.63
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$2.63
Typical High
$3.16
Johns Hopkins Employer Health Plan
Setting
Professional
Modifier
None
Typical Low
$5.37
Median
$5.37
Typical High
$5.37
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$3.72
Median
$5.37
Typical High
$7.94
United
Setting
Professional
Modifier
None
Typical Low
$2.04
Median
$2.57
Typical High
$3.98
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$2.57
Median
$2.57
Typical High
$4.47

Where Maryland sits

The same service costs 2.1 times more in Hawaii than in Connecticut. 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.

Maryland· 31st of 51

$3.16

HI $5.62CT $2.63

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.