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Ostomy Pouch, Drainable, with Barrier, with Filter

Pennsylvania rates for HCPCS A4424

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

Rates data updated July 2026.

Facilitymedian $11 · 10th–90th $3$350%10%20%10th90th$11Professionalmedian $4 · 10th–90th $3$70%20%10th90th$4$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$3.24
Median
$3.24
Typical High
$5.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$4.07
Typical High
$6.31
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$6.76
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$4.37
Typical High
$4.37
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$6.61
Typical High
$6.61
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
$4.07
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$7.41
Typical High
$12.88
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$6.76
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$4.79
Typical High
$6.76
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.68
Median
$5.01
Typical High
$5.01
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$3.24
Typical High
$5.13
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$4.07
Typical High
$5.50
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$6.17
Typical High
$6.17
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$23.99
Typical High
$38.90
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$6.31
Typical High
$6.31
United
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$3.02
Typical High
$4.27
United
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$3.31
Typical High
$6.92