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

Nebraska 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?

$3.39

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $3.39 for this service. The price depends on where it is billed: about $3.39 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 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$3.39$1.82 to $3.39
FacilityA hospital or hospital-owned outpatient department$5.37$3.39 to $7.08

How much rates vary

Facilitymedian $5 · 10th to 90th $2 to $79Professionalmedian $3 · 10th to 90th $2 to $4
$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
$4.37
Median
$4.37
Typical High
$4.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.58
Median
$3.39
Typical High
$4.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$5.01
Typical High
$5.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.63
Typical High
$5.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$6.03
Typical High
$10.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$4.27
Median
$7.41
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$2.57
Typical High
$5.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$5.75
Median
$5.75
Typical High
$14.13
Midlands
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$5.89
Midlands
Setting
Professional
Modifier
Global
Typical Low
$7.24
Median
$12.88
Typical High
$14.13
United
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$3.16
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$2.51
Typical High
$4.07

Where Nebraska 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.

Nebraska $3.39 · 30th 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.