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Ostomy Pouch, Closed, Locking Flange, with Filter

South Carolina 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%20%10th90th$2Professionalmedian $2 · 10th–90th $1$20%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
$2.04
Median
$2.04
Typical High
$2.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.17
Median
$2.04
Typical High
$2.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$1.66
Typical High
$1.66
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$2.40
Typical High
$2.63
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.63
Typical High
$3.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$1.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$3.55
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.29
Typical High
$1.66
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1.58
Median
$2.40
Typical High
$4.17
Medcost
Setting
Professional
Modifier
Global
Typical Low
$0.71
Median
$0.71
Typical High
$0.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$1.74
Typical High
$1.74
United
Setting
Facility
Modifier
Global
Typical Low
$0.83
Median
$1.02
Typical High
$2.63
United
Setting
Professional
Modifier
Global
Typical Low
$0.85
Median
$1.23
Typical High
$1.66