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Ostomy Barrier with Flange, Flat, over 4x4

Hawaii rates for HCPCS A4415

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

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $3$70%20%10th90th$3Professionalmedian $9 · 10th–90th $4$90%20%40%10th90th$9$5.0$10.0

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
Professional
Modifier
Global
Typical Low
$4.07
Median
$4.07
Typical High
$4.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.37
Typical High
$6.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$7.76
Typical High
$10.47
HMSA
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$8.51
Typical High
$12.02
United
Setting
Facility
Modifier
Global
Typical Low
$2.75
Median
$2.82
Typical High
$3.24
United
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$5.89
Typical High
$10.47