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Ostomy Barrier with Flange, Flat, over 4x4

Wisconsin 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 $9 · 10th–90th $7$150%20%40%10th90th$9Professionalmedian $8 · 10th–90th $4$140%20%10th90th$8$5.0$10.0$20.0$50.0$100.0

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
$4.90
Median
$4.90
Typical High
$4.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.90
Median
$4.90
Typical High
$7.24
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$14.13
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$7.94
Median
$7.94
Typical High
$9.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$26.92
Typical High
$43.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$12.30
Typical High
$16.22
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$4.68
Median
$7.24
Typical High
$12.02
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$7.59
Median
$12.59
Typical High
$15.49
Medica
Setting
Facility
Modifier
Global
Typical Low
$4.79
Median
$8.32
Typical High
$79.43
Medica
Setting
Professional
Modifier
Global
Typical Low
$3.55
Median
$4.17
Typical High
$9.12
Molina
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$13.49
Typical High
$13.49
Network Health
Setting
Professional
Modifier
Global
Typical Low
$6.03
Median
$9.55
Typical High
$16.60
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$4.68
Median
$7.24
Typical High
$12.02
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$4.79
Typical High
$8.32
Quartz
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$12.88
Typical High
$20.89
Quartz
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$17.38
Typical High
$79.43
Quartz
Setting
Professional
Modifier
Global
Typical Low
$4.27
Median
$12.59
Typical High
$42.66
Security Health
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
Security Health
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.51
United
Setting
Facility
Modifier
Global
Typical Low
$2.75
Median
$3.80
Typical High
$8.51
United
Setting
Professional
Modifier
Global
Typical Low
$2.75
Median
$4.17
Typical High
$7.24