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Indiana 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
$7.17 / $7.17 / $8.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.62 / $5.32 / $7.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.20 / $4.20 / $8.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.20 / $4.20 / $5.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.29 / $8.80 / $12.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $9.22 / $11.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.03 / $5.03 / $5.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.03 / $8.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.37 / $3.99 / $5.47