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Ostomy Pouch, Closed, Locking Flange, with Filter

Minnesota 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?

$2.40

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $2.40 for this service. The price depends on where it is billed: about $2.40 from a physician practice, and about $2.69 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.40$1.82 to $3.02
FacilityA hospital or hospital-owned outpatient department$2.69$1.91 to $7.59

How much rates vary

Facilitymedian $3 · 10th to 90th $2 to $22Professionalmedian $2 · 10th to 90th $1 to $4
$1$2$5$10$20$50facility $3professional $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
$1.91
Median
$1.91
Typical High
$1.91
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.86
Median
$1.91
Typical High
$1.91
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$2.45
Median
$3.16
Typical High
$4.47
BCBS Minnesota
Setting
Professional
Modifier
None
Typical Low
$2.09
Median
$2.63
Typical High
$2.63
Cigna
Setting
Facility
Modifier
None
Typical Low
$1.55
Median
$8.91
Typical High
$22.39
Cigna
Setting
Professional
Modifier
None
Typical Low
$3.02
Median
$3.16
Typical High
$3.80
Health Partners
Setting
Facility
Modifier
None
Typical Low
$5.62
Median
$8.91
Typical High
$21.38
Health Partners
Setting
Professional
Modifier
None
Typical Low
$3.02
Median
$3.02
Typical High
$3.02
Medica
Setting
Facility
Modifier
None
Typical Low
$1.12
Median
$2.69
Typical High
$79.43
Medica
Setting
Professional
Modifier
None
Typical Low
$1.05
Median
$1.23
Typical High
$12.88
United
Setting
Professional
Modifier
None
Typical Low
$0.85
Median
$1.23
Typical High
$2.24
8 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$0.95
Median
$0.95
Typical High
$0.95
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$0.38
Median
$0.38
Typical High
$0.38
Aetna
Setting
Facility
Modifier
55 · Aftercare only
Typical Low
$0.28
Median
$0.28
Typical High
$0.28
Aetna
Setting
Facility
Modifier
56 · Pre-op care only
Typical Low
$0.19
Median
$0.19
Typical High
$0.19
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.93
Median
$0.95
Typical High
$0.95
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.37
Median
$0.38
Typical High
$0.38
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.28
Median
$0.28
Typical High
$0.28
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.19
Median
$0.19
Typical High
$0.19

Where Minnesota 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.

Minnesota· 10th of 51

$2.40

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.