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Ostomy Pouch, Closed, Locking Flange, with Filter

Washington 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 $3 · 10th–90th $1$50%20%10th90th$3Professionalmedian $2 · 10th–90th $1$50%10%20%10th90th$2$0.0$0.1$0.5$2.0$10.0$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
$1.48
Median
$1.48
Typical High
$3.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.76
Median
$1.48
Typical High
$11.22
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.24
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$2.24
Median
$2.24
Typical High
$2.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.55
Median
$1.66
Typical High
$1.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.32
Median
$1.32
Typical High
$1.55
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$1.45
Median
$2.82
Typical High
$5.75
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1.45
Median
$3.31
Typical High
$5.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$1.82
Median
$2.19
Typical High
$72.44
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$2.34
Median
$2.51
Typical High
$2.57
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$2.57
Typical High
$2.57
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$2.29
Typical High
$4.17
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.14
Typical High
$2.51
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.24
Typical High
$2.88
United
Setting
Facility
Modifier
Global
Typical Low
$1.00
Median
$1.10
Typical High
$1.48
United
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.20
Typical High
$2.09
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$2.24
Typical High
$3.98