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Ostomy Pouch, Closed, Locking Flange, with Filter

New Jersey 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?

$1.32

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $1.32 for this service. Most negotiated rates run $1.26 to $1.74.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $2
$1$2facility $2professional $1

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.91
Median
$1.26
Typical High
$1.26
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.91
Median
$1.26
Typical High
$1.26
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.46
Median
$0.65
Typical High
$0.65
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.18
Median
$0.25
Typical High
$0.25
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.14
Median
$0.19
Typical High
$0.19
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.09
Median
$0.13
Typical High
$0.13
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
$1.55
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$1.48
Median
$3.16
Typical High
$3.47
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
United
Setting
Professional
Modifier
None
Typical Low
$1.00
Median
$1.38
Typical High
$2.57

Where New Jersey 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.

New Jersey· 51st of 51

$1.32

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.