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Ostomy Pouch, Closed, Locking Flange, with Filter

Nebraska rates for HCPCS A4423

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

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $1$790%20%10th90th$3Professionalmedian $2 · 10th–90th $1$20%20%40%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
$2.14
Median
$2.14
Typical High
$2.14
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.79
Median
$1.70
Typical High
$2.14
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.29
Median
$2.51
Typical High
$2.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.66
Typical High
$2.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.55
Median
$3.02
Typical High
$5.50
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.09
Median
$3.63
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$1.29
Typical High
$2.75
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2.82
Median
$2.88
Typical High
$5.50
Midlands
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$6.46
Typical High
$6.92
United
Setting
Facility
Modifier
Global
Typical Low
$0.93
Median
$1.58
Typical High
$2.63
United
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$1.26
Typical High
$2.04