go back

Ostomy Pouch, Drainable, Nonlocking Flange, with Filter

Tennessee 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 $5 · 10th–90th $2$850%20%40%10th90th$5Professionalmedian $3 · 10th–90th $2$40%10%20%10th90th$3$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
$2.57
Median
$2.95
Typical High
$4.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.04
Median
$3.09
Typical High
$4.37
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$2.57
Typical High
$2.88
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
$3.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.02
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$37.15
Typical High
$37.15
United
Setting
Facility
Modifier
Global
Typical Low
$1.91
Median
$2.29
Typical High
$5.13
United
Setting
Professional
Modifier
Global
Typical Low
$1.58
Median
$2.34
Typical High
$2.95