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Utah rates for HCPCS A4315

Insertion Tray With Drainage Bag With Indwelling Catheter Foley Type Two-Way All Silicone (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.09 / $10.09 / $10.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.09 / $19.64 / $106.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.29 / $22.13 / $22.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.80 / $22.13 / $26.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.05 / $27.00 / $36.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.50 / $25.80 / $38.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.24 / $15.62 / $17.50