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Ostomy Barrier with Flange, Flat, over 4x4

Illinois 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 October 2026.

How much does Ostomy Barrier with Flange, Flat, over 4x4 cost?

$5.37

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $5.37 for this service. The price depends on where it is billed: about $5.13 from a physician practice, and about $17.78 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5.13$4.17 to $6.46
FacilityA hospital or hospital-owned outpatient department$17.78$8.71 to $40.74

How much rates vary

Facilitymedian $18 · 10th to 90th $5 to $69Professionalmedian $5 · 10th to 90th $4 to $10
$5$10$20$50$100facility $18professional $5

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3.89
Median
$4.68
Typical High
$8.51
Aetna
Setting
Professional
Modifier
None
Typical Low
$3.89
Median
$4.68
Typical High
$7.24
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.59
Median
$0.71
Typical High
$1.07
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.39
Median
$0.47
Typical High
$0.72
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$13.49
Median
$21.88
Typical High
$74.13
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$3.98
Median
$6.46
Typical High
$6.46
Cigna
Setting
Facility
Modifier
None
Typical Low
$5.01
Median
$5.01
Typical High
$5.37
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.27
Median
$4.27
Typical High
$5.89
Hally Health
Setting
Professional
Modifier
None
Typical Low
$8.13
Median
$10.00
Typical High
$15.14
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
Molina
Setting
Professional
Modifier
None
Typical Low
$7.08
Median
$7.08
Typical High
$7.08
United
Setting
Professional
Modifier
None
Typical Low
$3.24
Median
$4.17
Typical High
$9.77

Where Illinois sits

The same service costs 2.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Illinois· 24th of 51

$5.37

HI $8.91DE $4.27

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.