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Montana rates for HCPCS A4415

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 in, each

Facilitymedian $8 · 10th–90th $5–$100%20%40%10th90th$8Professionalmedian $7 · 10th–90th $3–$110%10%10th90th$7$2.0$5.0$10.0$20.0$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $6.03 / $10.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $8.71 / $8.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $8.71 / $8.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $8.13 / $15.85
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $8.13 / $15.85
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $7.76 / $10.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $8.71 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.82 / $3.24 / $3.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.55 / $4.79