go back

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

New Hampshire 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?

$3.16

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $3.16 for this service. The price depends on where it is billed: about $3.24 from a physician practice, and about $2.75 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$3.24$2.57 to $4.57
FacilityA hospital or hospital-owned outpatient department$2.75$2.75 to $3.31

How much rates vary

Facilitymedian $3 · 10th to 90th $2 to $3Professionalmedian $3 · 10th to 90th $2 to $5
$2.0$5.0$10.0$20.0facility $3professional $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
$2.75
Median
$2.75
Typical High
$3.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.75
Typical High
$3.31
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.75
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
$3.63
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$4.57
Typical High
$8.51
United
Setting
Facility
Modifier
Global
Typical Low
$1.35
Median
$2.00
Typical High
$2.14
United
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.95
Typical High
$4.57
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$6.92
Median
$6.92
Typical High
$17.38

Where New Hampshire 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.

New Hampshire $3.16 · 42nd 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.