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

Minnesota 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?

$5.25

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $5.25 for this service. The price depends on where it is billed: about $5.25 from a physician practice, and about $15.49 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 6 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$5.25$4.27 to $5.25
FacilityA hospital or hospital-owned outpatient department$15.49$5.75 to $22.39

How much rates vary

Facilitymedian $15 · 10th to 90th $3 to $43Professionalmedian $5 · 10th to 90th $3 to $6
$0.1$1.0$10.0$100.0facility $15professional $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
$3.31
Median
$3.31
Typical High
$3.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$3.31
Typical High
$4.37
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$6.17
Typical High
$8.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$5.25
Typical High
$5.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$19.50
Typical High
$53.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.92
Typical High
$7.59
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$21.38
Typical High
$42.66
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$7.08
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$5.25
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.19
Typical High
$5.75
United
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$2.00
Typical High
$2.34
United
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$2.57
Typical High
$7.24

Where Minnesota 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.

Minnesota $5.25 · 3rd 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.