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Ostomy Pouch, Closed, Locking Flange, with Filter

Montana 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?

$2.69

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $2.69 for this service. The price depends on where it is billed: about $2.69 from a physician practice, and about $2.88 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$2.69$2.04 to $2.69
FacilityA hospital or hospital-owned outpatient department$2.88$2.63 to $151

How much rates vary

Facilitymedian $3 · 10th to 90th $2 to $155Professionalmedian $3 · 10th to 90th $1 to $79
$1$2$5$10$20$50$100facility $3professional $3

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
Professional
Modifier
None
Typical Low
$0.71
Median
$2.24
Typical High
$3.55
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$2.40
Median
$2.69
Typical High
$2.69
Cigna
Setting
Professional
Modifier
None
Typical Low
$2.24
Median
$2.69
Typical High
$2.69
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$2.00
Median
$3.31
Typical High
$154.88
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$2.63
Median
$2.88
Typical High
$162.18
Providence
Setting
Facility
Modifier
None
Typical Low
$1.58
Median
$2.69
Typical High
$2.69
Providence
Setting
Professional
Modifier
None
Typical Low
$2.04
Median
$2.69
Typical High
$79.43
United
Setting
Professional
Modifier
None
Typical Low
$1.05
Median
$1.10
Typical High
$1.82

Where Montana 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.

Montana· 3rd of 51

$2.69

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.