go back

Ostomy Pouch, Closed, Locking Flange, with Filter

Ohio 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$30%20%10th90th$2Professionalmedian $2 · 10th–90th $1$30%20%10th90th$2$0.0$0.1$0.5$2.0$10.0

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
$1.62
Median
$2.19
Typical High
$2.75
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.62
Typical High
$2.24
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.09
Median
$2.09
Typical High
$2.09
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.58
Typical High
$3.39
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.63
Typical High
$2.63
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1.29
Median
$2.19
Typical High
$3.09
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$2.34
Typical High
$3.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$1.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.66
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$1.66
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.10
Median
$1.55
Typical High
$2.24
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$2.63
Median
$2.95
Typical High
$5.50
United
Setting
Facility
Modifier
Global
Typical Low
$0.83
Median
$1.17
Typical High
$2.63
United
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$1.23
Typical High
$1.86