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Ostomy Pouch, Closed, Locking Flange, with Filter

Rhode Island 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 $5 · 10th–90th $1$60%10%20%10th90th$5Professionalmedian $1 · 10th–90th $1$20%20%10th90th$1$1.0$2.0$5.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$1.12
Typical High
$2.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.80
Median
$5.13
Typical High
$6.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.38
Typical High
$2.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$1.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.32
United
Setting
Facility
Modifier
Global
Typical Low
$1.17
Median
$1.17
Typical High
$1.35
United
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.48
Typical High
$2.14