go back

Utah rates for HCPCS A4306

Disposable drug delivery system, flow rate of less than 50 ml per hour

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $10.00 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $10.23 / $75.86
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.18 / $13.18
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $30.20 / $36.31
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $10.96 / $12.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $7.76 / $12.02