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Ostomy Barrier with Flange, Flat, over 4x4

Michigan 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 $4$380%10%20%10th90th$9Professionalmedian $6 · 10th–90th $4$80%20%10th90th$6$0.1$0.5$2.0$10.0$50.0

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
$6.31
Median
$6.31
Typical High
$6.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$5.37
Typical High
$7.24
BCBS
Setting
Facility
Modifier
Global
Typical Low
$10.96
Median
$25.12
Typical High
$47.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$8.71
CareSource
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$5.89
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$5.50
Median
$6.03
Typical High
$17.78
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$6.76
Typical High
$10.23
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$3.98
Median
$3.98
Typical High
$6.92
United
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$3.24
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$2.75
Median
$3.89
Typical High
$6.03