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Ostomy Barrier with Flange, Extended Wear, Convex, over 4x4

South Dakota rates for HCPCS A4408

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 in, each

Rates data updated July 2026.

Facilitymedian $15 · 10th–90th $8$190%10%20%10th90th$15Professionalmedian $13 · 10th–90th $9$200%10%10th90th$13$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$9.33
Typical High
$18.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$15.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$19.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$15.14
Typical High
$25.70
Medica
Setting
Professional
Modifier
Global
Typical Low
$5.50
Median
$8.71
Typical High
$69.18
Midlands
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$15.14
Typical High
$15.14
Midlands
Setting
Facility
Modifier
Global
Typical Low
$15.49
Median
$15.49
Typical High
$15.49
Midlands
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$12.59
Typical High
$24.55
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$13.80
Typical High
$18.20
United
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$6.46
Typical High
$9.77
United
Setting
Professional
Modifier
Global
Typical Low
$4.57
Median
$9.12
Typical High
$16.22
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$11.22