go back

California rates for HCPCS A4415

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 in, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $2.46 / $24.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $3.78 / $24.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.64 / $9.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.20 / $4.20 / $7.79
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.82 / $11.46 / $17.71
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $17.96 / $31.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.54 / $5.03 / $6.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $4.28 / $5.33
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.70 / $8.38 / $10.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.03 / $5.87 / $12.99
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.73 / $41.73 / $62.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.15 / $25.15 / $25.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $7.41 / $8.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.03 / $7.64
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.79 / $15.79 / $15.79
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.70 / $9.80 / $12.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.23 / $3.55 / $7.55