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Ostomy Pouch, Drainable, Nonlocking Flange, with Filter

Maine 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 $3 · 10th–90th $2$40%20%10th90th$3Professionalmedian $4 · 10th–90th $2$40%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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.35
Median
$2.63
Typical High
$4.37
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$3.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.02
Typical High
$3.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.31
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$5.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1.38
Median
$2.88
Typical High
$3.80
United
Setting
Facility
Modifier
Global
Typical Low
$1.38
Median
$1.95
Typical High
$2.69
United
Setting
Professional
Modifier
Global
Typical Low
$1.95
Median
$4.27
Typical High
$4.37