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Ostomy Pouch, Closed, without Barrier, with Filter

Utah 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%90th$1Professionalmedian $2 · 10th–90th $1$110%10%20%10th90th$2$0.0$0.1$0.5$2.0$10.0$50.0

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
$0.69
Median
$0.69
Typical High
$0.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.69
Median
$1.62
Typical High
$10.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$1.70
Typical High
$1.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$1.45
Typical High
$1.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.51
Median
$1.86
Typical High
$2.51
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.82
Typical High
$2.82
Select Health
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.57
Select Health
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$2.57
Typical High
$2.57
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$2.57
Typical High
$3.09
United
Setting
Facility
Modifier
Global
Typical Low
$0.85
Median
$0.98
Typical High
$1.07
United
Setting
Professional
Modifier
Global
Typical Low
$0.83
Median
$1.07
Typical High
$1.91