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Ostomy Barrier with Flange, Flat, over 4x4

Vermont 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%20%40%10th90th$4Professionalmedian $6 · 10th–90th $4$80%20%40%10th90th$6$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$5.62
Typical High
$7.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$4.27
Typical High
$5.13
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$6.61
Median
$6.61
Typical High
$8.13
United
Setting
Facility
Modifier
Global
Typical Low
$2.82
Median
$2.95
Typical High
$3.80
United
Setting
Professional
Modifier
Global
Typical Low
$3.02
Median
$5.13
Typical High
$16.98