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

Virginia 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?

$3.24

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $3.24 for this service. The price depends on where it is billed: about $3.24 from a physician practice, and about $4.07 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 8 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 $3.72
FacilityA hospital or hospital-owned outpatient department$4.07$3.47 to $5.37

How much rates vary

Facilitymedian $4 · 10th to 90th $3 to $9Professionalmedian $3 · 10th to 90th $3 to $5
$0.1$1.0$10.0$100.0$1.0K$10.0Kfacility $4professional $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
$3.24
Median
$3.24
Typical High
$3.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$3.24
Typical High
$3.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$5.37
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$3.55
Typical High
$3.63
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
$2.63
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$5.37
Typical High
$7.41
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$3.72
Typical High
$5.62
Medcost
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$3.80
Typical High
$6.31
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$3.24
Typical High
$3.47
Sentara
Setting
Facility
Modifier
Global
Typical Low
$3.55
Median
$4.57
Typical High
$17.78
Sentara
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$4.57
Typical High
$17.78
United
Setting
Facility
Modifier
Global
Typical Low
$1.48
Median
$2.04
Typical High
$2.63
United
Setting
Professional
Modifier
Global
Typical Low
$2.19
Median
$2.57
Typical High
$4.07

Where Virginia 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.

Virginia $3.24 · 34th 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.