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

South Carolina 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?

$4.17

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $4.17 for this service. The price depends on where it is billed: about $4.17 from a physician practice, and about $4.17 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$4.17$2.88 to $4.37
FacilityA hospital or hospital-owned outpatient department$4.17$3.55 to $5.25

How much rates vary

Facilitymedian $4 · 10th to 90th $2 to $7Professionalmedian $4 · 10th to 90th $2 to $5
$0.1$0.2$1.0$5.0$20.0facility $4professional $4

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
$4.17
Median
$4.17
Typical High
$4.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$4.17
Typical High
$4.57
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.39
Median
$4.79
Typical High
$5.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$5.37
Typical High
$7.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$3.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$7.08
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.31
Medcost
Setting
Facility
Modifier
Global
Typical Low
$3.09
Median
$4.79
Typical High
$8.51
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.41
Typical High
$1.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$3.55
Typical High
$3.55
United
Setting
Facility
Modifier
Global
Typical Low
$1.66
Median
$2.04
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$2.45
Typical High
$3.39

Where South Carolina 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.

South Carolina $4.17 · 14th 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.