go back

Ostomy Pouch, Drainable, with Barrier, with Filter

Illinois rates for HCPCS A4424

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

Rates data updated July 2026.

Facilitymedian $7 · 10th–90th $4$350%20%10th90th$7Professionalmedian $4 · 10th–90th $3$70%20%10th90th$4$0.1$0.2$1.0$5.0$20.0$100.0

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
$3.72
Median
$3.72
Typical High
$6.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.09
Median
$4.07
Typical High
$6.76
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$3.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$16.98
Typical High
$57.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$5.13
Typical High
$5.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$7.41
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$7.24
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$8.13
Typical High
$13.80
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$8.71
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$3.16
United
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$6.76
Typical High
$6.76
United
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$3.31
Typical High
$5.75