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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 July 2026.

Facilitymedian $9 · 10th–90th $5$450%20%10th90th$9Professionalmedian $6 · 10th–90th $4$90%20%10th90th$6$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4.68
Median
$4.68
Typical High
$8.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$5.13
Typical High
$8.51
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12.59
Median
$21.88
Typical High
$72.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$6.46
Typical High
$6.46
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$9.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$9.12
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$11.22
Typical High
$16.60
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$7.08
United
Setting
Facility
Modifier
Global
Typical Low
$2.69
Median
$8.51
Typical High
$8.51
United
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$4.17
Typical High
$7.41