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Ostomy Pouch, Drainable, with Barrier, with Filter

Texas rates for HCPCS A4424

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

Rates data updated July 2026.

Facilitymedian $6 · 10th–90th $4$180%10%10th90th$6Professionalmedian $4 · 10th–90th $3$60%20%10th90th$4$0.1$0.5$5.0$50.0$500.0

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
$1.62
Median
$4.27
Typical High
$4.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.88
Median
$4.27
Typical High
$5.75
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$4.07
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5.25
Median
$7.59
Typical High
$18.62
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.16
Median
$3.16
Typical High
$3.55
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$5.37
Typical High
$8.32
Christus
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$4.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$3.98
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$50.12
Typical High
$50.12
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$5.50
Typical High
$9.55
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$5.75
Typical High
$6.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.72
Median
$3.72
Typical High
$81.28
Providence
Setting
Facility
Modifier
Global
Typical Low
$3.31
Median
$5.37
Typical High
$9.55
Providence
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$3.39
Typical High
$4.27
United
Setting
Facility
Modifier
Global
Typical Low
$2.24
Median
$3.02
Typical High
$6.76
United
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$3.09
Typical High
$4.07
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$3.31
Median
$6.76
Typical High
$9.12