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Ostomy Pouch, Drainable, Locking Flange, with Filter

Utah rates for HCPCS A4427

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

Rates data updated July 2026.

Facilitymedian $1 · 10th–90th $1$20%50%90th$1Professionalmedian $3 · 10th–90th $1$170%10%20%10th90th$3$0.1$0.2$1.0$5.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.07
Median
$1.07
Typical High
$1.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.07
Median
$2.51
Typical High
$16.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2.34
Median
$2.34
Typical High
$2.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$2.75
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.82
Typical High
$3.80
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$2.14
Median
$2.82
Typical High
$4.37
Select Health
Setting
Facility
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$3.98
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$3.98
Typical High
$3.98
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$3.98
Typical High
$4.79
United
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$1.51
Typical High
$1.74
United
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.66
Typical High
$3.02