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Minnesota 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
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $7.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $9.77 / $14.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $8.32 / $8.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $31.62 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $11.22 / $12.30
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $31.62 / $58.88
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $9.77 / $10.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.63 / $8.32 / $79.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.55 / $9.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $3.24 / $3.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.98 / $9.77