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Ostomy Pouch, Drainable, Nonlocking Flange, with Filter

Nationwide rates for HCPCS A4425

Ostomy pouch, drainable; for use on barrier with nonlocking flange, with filter (two-piece system), each

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $2$110%20%10th90th$4Professionalmedian $3 · 10th–90th $2$60%20%40%10th90th$3$0.1$1.0$20.0$500.0$10.0K$200.0K

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
$2.19
Median
$3.39
Typical High
$5.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.70
Median
$3.16
Typical High
$4.37
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$2.40
Typical High
$6.03
BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.82
Typical High
$5.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.16
Typical High
$19.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$7.08
United
Setting
Facility
Modifier
Global
Typical Low
$1.62
Median
$2.24
Typical High
$5.13
United
Setting
Professional
Modifier
Global
Typical Low
$1.66
Median
$2.51
Typical High
$4.47