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Ostomy Pouch, Closed, Locking Flange, with Filter

Tennessee 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?

$1.55

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $1.55 for this service. Most negotiated rates run $1.32 to $2.00.

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 $2 to $2Professionalmedian $2 · 10th to 90th $1 to $13
$1$2$5$10$20facility $2professional $2

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1.35
Median
$1.35
Typical High
$1.35
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.35
Median
$1.58
Typical High
$2.29
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.68
Median
$0.79
Typical High
$1.12
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.27
Median
$0.32
Typical High
$0.45
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.20
Median
$0.24
Typical High
$0.34
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.13
Median
$0.16
Typical High
$0.23
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$1.55
Median
$2.00
Typical High
$2.00
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
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$13.18
Median
$19.95
Typical High
$19.95
United
Setting
Professional
Modifier
None
Typical Low
$0.76
Median
$1.20
Typical High
$1.48

Where Tennessee 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.

Tennessee· 36th of 51

$1.55

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.