Assura Original 1-piece closed

ColoplastPouches1-pieceClosedFlat

Brand
Coloplast
Category
Pouches
System
1-piece
Pouch type
Closed
Barrier type
Flat (from product name)
Opening
Not found in our sources
Filter
Yes
Box quantity
30
Flange sizes
Not found in our sources
HCPCS code(s)
A4416 (Coloplast product page (variant name))
Lowest cash price seen
From $78.16 / Box of 30 ($2.61 each)
Vitality Medical, Nov 4, 2026
Source
products.coloplast.us · checked Nov 4, 2026

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Sizes, codes and prices

Prices are cash prices one retailer listed on the date shown, per the retailer's unit. Retailer links are marked as sponsored for search engines and may become affiliate links later. We do not take referral fees from suppliers that bill Medicare. The retailer page says the manufacturer labels this item Rx only.

CodeDescription / sizeBoxHCPCSPrice seen
12110Mini (5in / 170mL) - Stoma size: 20-65mm | 13/16 - 2 1/2in - with filter - Opaque30 per boxA4416$96.17 / Box of 30
Vitality Medical · Nov 4, 2026
12130Midi (7in / 350mL) - Stoma size: 20-65mm | 13/16 - 2 1/2in - with filter Transparent30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12134Midi (7in / 350mL) - Stoma size: 25mm | 1in - with filter, Transparent30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12135Midi (7in / 350mL) - Stoma size: 30mm | 1 3/16in - with filter Transparent30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12136Midi (7in / 350mL) - Stoma size: 35mm | 1 3/8in - with filter, Transparent30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12140Midi (7in / 350mL) - Stoma size: 20-65mm | 13/16 - 2 1/2in - with filter Opaque30 per boxA4416$108.55 / Box of 30
Vitality Medical · Nov 4, 2026
12144Midi (7in / 350mL) - Stoma size: 25mm | 1in - with filter, Opaque30 per boxA4416$78.16 / Box of 30
Vitality Medical · Nov 4, 2026
12145Midi (7in / 350mL) - Stoma size: 30mm | 1 3/16in - with filter, Opaque30 per boxA4416$104.08 / Box of 30
Vitality Medical · Nov 4, 2026
12146Midi (7in / 350mL) - Stoma size: 35mm | 1 3/8in - with filter Opaque30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12147Midi (7in / 350mL) - Stoma size: 40mm | 1 9/16in - with filter Opaque30 per boxA4416$96.62 / Box of 30
Vitality Medical · Nov 4, 2026
12149Midi (7in / 350mL) - Stoma size: 50mm | 2in - with filter, Opaque30 per boxA4416$101.94 / Box of 30
Vitality Medical · Nov 4, 2026
12170Maxi (8 1/2in / 530mL) - Stoma size: 20-75mm | 13/16 - 3in - with filter Opaque30 per boxA4416$96.17 / Box of 30
Vitality Medical · Nov 4, 2026
12174Maxi (8 1/2in / 530mL) - Stoma size: 25mm | 1in - with filter, Opaque30 per boxA4416$104.10 / Box of 30
Vitality Medical · Nov 4, 2026
12175Maxi (8 1/2in / 530mL) - Stoma size: 30mm | 1 3/16in - with filter, Opaque30 per boxA4416$95.51 / Box of 30
Vitality Medical · Nov 4, 2026
12176Maxi (8 1/2in / 530mL) - Stoma size: 35mm | 1 3/8in - with filter Opaque30 per boxA4416$101.94 / Box of 30
Vitality Medical · Nov 4, 2026
12177Maxi (8 1/2in / 530mL) - Stoma size: 40mm | 1 9/16in - with filter Opaque30 per boxA4416$96.62 / Box of 30
Vitality Medical · Nov 4, 2026

Medicare usual maximums for these codes

From our Medicare guide (LCD L33828). Informational only; coverage depends on your plan and documentation. Confirm with your supplier or plan.

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