go back

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 July 2026.

Facilitymedian $2 · 10th–90th $1$850%20%40%10th90th$2Professionalmedian $2 · 10th–90th $1$20%20%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0

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
$1.35
Median
$1.51
Typical High
$2.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.62
Typical High
$2.29
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$1.70
Typical High
$1.70
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$2.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.55
Typical High
$1.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.55
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$19.50
Typical High
$19.50
United
Setting
Facility
Modifier
Global
Typical Low
$1.00
Median
$1.17
Typical High
$2.63
United
Setting
Professional
Modifier
Global
Typical Low
$0.83
Median
$1.20
Typical High
$1.51