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Ostomy Barrier with Flange, Flat, over 4x4

Utah 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 October 2026.

How much does Ostomy Barrier with Flange, Flat, over 4x4 cost?

$4.68

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $4.68 for this service. The price depends on where it is billed: about $5.01 from a physician practice, and about $2.29 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5.01$3.39 to $6.03
FacilityA hospital or hospital-owned outpatient department$2.29$2.29 to $5.01

How much rates vary

Facilitymedian $2 · 10th to 90th $2 to $5Professionalmedian $5 · 10th to 90th $2 to $8
$5$10$20$50facility $2professional $5

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$2.29
Aetna
Setting
Professional
Modifier
None
Typical Low
$2.29
Median
$2.29
Typical High
$2.63
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.35
Median
$0.35
Typical High
$0.39
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.23
Median
$0.23
Typical High
$0.26
Cigna
Setting
Facility
Modifier
None
Typical Low
$5.01
Median
$5.01
Typical High
$5.37
Cigna
Setting
Professional
Modifier
None
Typical Low
$4.27
Median
$4.27
Typical High
$5.01
Molina
Setting
Professional
Modifier
None
Typical Low
$6.17
Median
$6.17
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$6.03
Median
$6.03
Typical High
$6.03
Select Health
Setting
Facility
Modifier
None
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Select Health
Setting
Professional
Modifier
None
Typical Low
$4.27
Median
$8.51
Typical High
$8.51
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$5.37
Median
$6.92
Typical High
$10.23
United
Setting
Professional
Modifier
None
Typical Low
$2.75
Median
$3.55
Typical High
$6.92

Where Utah sits

The same service costs 2.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 38th of 51

$4.68

HI $8.91DE $4.27

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.