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

New Mexico 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 New Mexico, October 2026.

Insurers have agreed to pay about $3.16 for this service. The price depends on where it is billed: about $3.16 from a physician practice, and about $3.16 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$3.16$2.19 to $4.17
FacilityA hospital or hospital-owned outpatient department$3.16$1.41 to $3.72

How much rates vary

Facilitymedian $3 · 10th to 90th $1 to $4Professionalmedian $3 · 10th to 90th $2 to $5
$2$5$10facility $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
Facility
Modifier
None
Typical Low
$3.80
Median
$3.80
Typical High
$3.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$3.72
Typical High
$3.80
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$3.09
Median
$4.17
Typical High
$5.01
Cigna
Setting
Facility
Modifier
None
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$2.63
Typical High
$3.16
Molina
Setting
Professional
Modifier
None
Typical Low
$5.25
Median
$5.25
Typical High
$9.12
Providence
Setting
Facility
Modifier
None
Typical Low
$1.41
Median
$3.16
Typical High
$4.07
Providence
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$2.63
Typical High
$5.50
United
Setting
Professional
Modifier
None
Typical Low
$2.04
Median
$2.19
Typical High
$3.31

Where New Mexico 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.

New Mexico· 32nd 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.