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Ostomy Barrier with Flange, Flat, over 4x4

New Hampshire 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 $4 · 10th–90th $3$50%50%10th90th$4Professionalmedian $5 · 10th–90th $4$70%20%10th90th$5$2.0$5.0$10.0$20.0

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
$4.37
Median
$4.37
Typical High
$5.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$4.37
Typical High
$5.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$4.17
Typical High
$4.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$6.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$5.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$7.41
Typical High
$13.49
United
Setting
Facility
Modifier
Global
Typical Low
$2.19
Median
$3.24
Typical High
$3.47
United
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$4.79
Typical High
$7.41
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$11.22
Typical High
$12.30