go back

Utah rates for HCPCS A4238

Supply allowance for adjunctive, nonimplanted continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.41 / $133.41 / $133.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.41 / $180.22 / $362.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.94 / $160.94 / $160.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.50 / $144.59 / $240.98