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Ostomy Barrier with Flange, Flat, over 4x4

New Mexico 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 $6 · 10th–90th $2$90%10%10th90th$6Professionalmedian $5 · 10th–90th $2$140%10%20%10th90th$5$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
Setting
Facility
Modifier
Global
Typical Low
$6.03
Median
$6.03
Typical High
$6.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.45
Median
$5.89
Typical High
$36.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$6.76
Typical High
$6.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$12.30
Molina
Setting
Professional
Modifier
Global
Typical Low
$9.77
Median
$12.30
Typical High
$21.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$2.29
Median
$6.03
Typical High
$9.33
Providence
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$8.71
United
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$3.55
Typical High
$8.51
United
Setting
Professional
Modifier
Global
Typical Low
$3.24
Median
$3.55
Typical High
$5.37