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Ostomy Pouch, Drainable, Nonlocking Flange, with Filter

Oklahoma 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 $3$40%50%10th$4Professionalmedian $3 · 10th–90th $1$40%20%10th90th$3$1.0$2.0$5.0$10.0$20.0$50.0

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
$2.95
Median
$2.95
Typical High
$2.95
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$2.95
Typical High
$2.95
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$3.09
Median
$3.09
Typical High
$5.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.14
Median
$3.02
Typical High
$3.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.55
Medica
Setting
Facility
Modifier
Global
Typical Low
$2.95
Median
$3.55
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$2.40
Typical High
$6.17
United
Setting
Facility
Modifier
Global
Typical Low
$1.95
Median
$2.34
Typical High
$5.13
United
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$2.14
Typical High
$3.02