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Ostomy Pouch, Drainable, with Barrier, with Filter

Hawaii rates for HCPCS A4424

Ostomy pouch, drainable, with barrier attached, with filter (one piece), each

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $2$50%20%10th90th$3Professionalmedian $7 · 10th–90th $3$70%20%40%10th90th$7$2.0$5.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$3.24
Typical High
$3.72
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$4.27
Typical High
$5.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$6.17
Typical High
$8.32
HMSA
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$7.08
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$6.76
Typical High
$9.55
United
Setting
Facility
Modifier
Global
Typical Low
$2.19
Median
$2.24
Typical High
$2.57
United
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$4.68
Typical High
$8.32