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Ostomy Pouch, Drainable, with Barrier, with Filter

Indiana rates for HCPCS A4424

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

Rates data updated July 2026.

Facilitymedian $6 · 10th–90th $3$60%20%10th90th$6Professionalmedian $4 · 10th–90th $3$60%10%20%10th90th$4$2.0$5.0$10.0$20.0

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
$5.75
Median
$5.75
Typical High
$5.75
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$4.17
Typical High
$5.75
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$3.31
Typical High
$6.46
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$3.55
Typical High
$6.61
CareSource
Setting
Facility
Modifier
Global
Typical Low
$6.61
Median
$8.71
Typical High
$10.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$9.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$5.50
United
Setting
Facility
Modifier
Global
Typical Low
$2.19
Median
$2.57
Typical High
$6.76
United
Setting
Professional
Modifier
Global
Typical Low
$1.86
Median
$3.16
Typical High
$4.79