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Ostomy Pouch, Closed, Locking Flange, with Filter

New York 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 $2 · 10th–90th $1$40%50%10th90th$2Professionalmedian $2 · 10th–90th $1$40%20%10th90th$2$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$1.12
Median
$1.58
Typical High
$2.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.58
Typical High
$2.45
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.38
Median
$1.58
Typical High
$3.72
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.14
Typical High
$2.14
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.14
Typical High
$2.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.66
Typical High
$3.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.82
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$2.63
Median
$4.37
Typical High
$10.23
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.63
Typical High
$5.01
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$1.91
Typical High
$2.04
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$1.91
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$1.66
Typical High
$1.66
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$1.62
Median
$2.51
Typical High
$2.95
United
Setting
Facility
Modifier
Global
Typical Low
$0.91
Median
$1.12
Typical High
$7.41
United
Setting
Professional
Modifier
Global
Typical Low
$0.95
Median
$1.70
Typical High
$4.47
Univera
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$2.04
Univera
Setting
Professional
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$1.91