go back

Ostomy Pouch, Closed, without Barrier, with Filter

Wisconsin rates for HCPCS A4418

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

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $2$50%20%40%10th90th$3Professionalmedian $2 · 10th–90th $1$40%10%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$1.48
Median
$1.48
Typical High
$1.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$1.48
Typical High
$2.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$4.27
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$2.40
Typical High
$2.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$8.13
Typical High
$13.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$3.80
Typical High
$4.90
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$2.19
Typical High
$3.72
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$4.07
Typical High
$5.01
Medica
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$2.51
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.26
Typical High
$2.75
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$4.07
Median
$4.07
Typical High
$4.07
Network Health
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.88
Typical High
$5.01
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$1.41
Median
$2.19
Typical High
$3.72
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$1.45
Typical High
$2.51
Quartz
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$3.89
Typical High
$6.03
Quartz
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$5.25
Typical High
$79.43
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$3.89
Typical High
$12.88
Security Health
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.57
Security Health
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$2.57
United
Setting
Facility
Modifier
Global
Typical Low
$0.83
Median
$1.15
Typical High
$2.57
United
Setting
Professional
Modifier
Global
Typical Low
$0.83
Median
$1.26
Typical High
$2.19