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Ostomy Pouch, Closed, Locking Flange, with Filter

Utah 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?

$1.35

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $1.35 for this service. The price depends on where it is billed: about $1.45 from a physician practice, and about $0.71 from a hospital or other facility.

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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.45$1.07 to $1.86
FacilityA hospital or hospital-owned outpatient department$0.71$0.71 to $1.55

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $2
$1$2$5$10$20$50facility $1professional $1

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$0.71
Median
$0.71
Typical High
$0.71
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.71
Median
$0.71
Typical High
$0.71
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.36
Median
$0.36
Typical High
$0.41
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.14
Median
$0.14
Typical High
$0.16
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.11
Median
$0.11
Typical High
$0.12
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.07
Median
$0.07
Typical High
$0.08
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
Molina
Setting
Professional
Modifier
None
Typical Low
$1.91
Median
$1.91
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$1.86
Median
$1.86
Typical High
$1.86
Select Health
Setting
Facility
Modifier
None
Typical Low
$2.63
Median
$2.63
Typical High
$2.63
Select Health
Setting
Professional
Modifier
None
Typical Low
$1.32
Median
$2.63
Typical High
$2.63
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$1.66
Median
$2.19
Typical High
$3.16
United
Setting
Professional
Modifier
None
Typical Low
$0.85
Median
$1.10
Typical High
$2.14

Where Utah 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.

Utah· 46th of 51

$1.35

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.