go back

Ostomy Pouch, Closed, without Barrier, with Filter

New Hampshire rates for HCPCS A4418

Ostomy pouch, closed; without barrier attached, with filter (one piece), each

Rates data updated July 2026.

Facilitymedian $1 · 10th–90th $1$20%50%10th90th$1Professionalmedian $2 · 10th–90th $1$20%20%10th90th$2$1.0$2.0$5.0$10.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.32
Typical High
$1.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$1.70
Typical High
$2.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$1.45
Typical High
$1.74
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$2.19
Median
$2.19
Typical High
$4.07
United
Setting
Facility
Modifier
Global
Typical Low
$0.66
Median
$0.98
Typical High
$1.05
United
Setting
Professional
Modifier
Global
Typical Low
$0.89
Median
$1.45
Typical High
$2.19
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$17.38