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Ostomy Barrier with Flange, Flat, over 4x4

Pennsylvania 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 $12 · 10th–90th $4$450%20%10th90th$12Professionalmedian $5 · 10th–90th $4$80%20%10th90th$5$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$4.07
Median
$4.07
Typical High
$6.46
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.63
Median
$5.13
Typical High
$7.94
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$8.32
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$11.75
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$5.13
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$9.33
Typical High
$16.22
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$6.03
Typical High
$8.51
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$6.31
Typical High
$8.32
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$4.07
Median
$4.07
Typical High
$6.46
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$4.07
Median
$5.13
Typical High
$6.92
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$30.90
Typical High
$48.98
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$7.94
Typical High
$7.94
United
Setting
Facility
Modifier
Global
Typical Low
$2.82
Median
$3.80
Typical High
$5.37
United
Setting
Professional
Modifier
Global
Typical Low
$2.95
Median
$4.17
Typical High
$9.33