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Ostomy Pouch, Closed, Locking Flange, with Filter

Illinois rates for HCPCS A4423

Ostomy pouch, closed; for use on barrier with locking flange, with filter (two piece), each

Rates data updated October 2026.

How much does Ostomy Pouch, Closed, Locking Flange, with Filter cost?

$2.00

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $2.00 for this service. The price depends on where it is billed: about $2.00 from a physician practice, and about $6.46 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.00$1.32 to $2.09
FacilityA hospital or hospital-owned outpatient department$6.46$2.69 to $13.49

How much rates vary

Facilitymedian $6 · 10th to 90th $2 to $21Professionalmedian $2 · 10th to 90th $1 to $3
$1$2$5$10$20facility $6professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1.20
Median
$1.45
Typical High
$2.63
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.20
Median
$1.45
Typical High
$2.24
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.62
Median
$0.72
Typical High
$1.12
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.24
Median
$0.28
Typical High
$0.44
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.18
Median
$0.22
Typical High
$0.33
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.12
Median
$0.15
Typical High
$0.22
Ambetter
Setting
Professional
Modifier
None
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$5.01
Median
$8.13
Typical High
$22.91
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.55
Median
$1.55
Typical High
$1.66
Cigna
Setting
Professional
Modifier
None
Typical Low
$1.32
Median
$1.32
Typical High
$1.82
Hally Health
Setting
Professional
Modifier
None
Typical Low
$2.45
Median
$2.82
Typical High
$4.47
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$3.39
Median
$3.39
Typical High
$3.39
Molina
Setting
Professional
Modifier
None
Typical Low
$2.14
Median
$2.14
Typical High
$2.14
United
Setting
Professional
Modifier
None
Typical Low
$1.00
Median
$1.29
Typical High
$3.02

Where Illinois sits

The same service costs 2.3 times more in Kansas than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 19th of 51

$2.00

KS $3.09NJ $1.32

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.