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Ostomy Pouch, Drainable, Nonlocking Flange, with Filter

North Carolina 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$90%20%10th90th$4Professionalmedian $4 · 10th–90th $2$40%20%40%10th90th$4$0.1$0.2$1.0$5.0$20.0$100.0

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
$4.37
Median
$4.37
Typical High
$4.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$4.37
Typical High
$4.37
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$2.88
Typical High
$3.55
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$4.90
Typical High
$10.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$3.80
Typical High
$4.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3.02
Median
$3.02
Typical High
$3.16
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.24
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2.34
Median
$2.51
Typical High
$3.55
Medcost
Setting
Facility
Modifier
Global
Typical Low
$2.19
Median
$4.37
Typical High
$7.41
United
Setting
Facility
Modifier
Global
Typical Low
$1.70
Median
$3.24
Typical High
$5.13
United
Setting
Professional
Modifier
Global
Typical Low
$1.78
Median
$2.40
Typical High
$3.55
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$37.15