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Irrigation Tubing Set for Continuous Bladder Irrigation

Utah rates for HCPCS A4355

Irrigation tubing set for continuous bladder irrigation through a three-way indwelling Foley catheter, each

Rates data updated July 2026.

Facilitymedian $3 · 10th–90th $3$60%50%90th$3Professionalmedian $9 · 10th–90th $4$540%10%10th90th$9$0.1$0.5$2.0$10.0$50.0

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
$3.39
Median
$3.39
Typical High
$3.39
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3.39
Median
$9.55
Typical High
$53.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.89
Median
$5.89
Typical High
$6.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.13
Typical High
$5.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$6.31
Median
$9.33
Typical High
$32.36
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$5.89
Median
$7.59
Typical High
$11.75
Select Health
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Select Health
Setting
Professional
Modifier
Global
Typical Low
$5.37
Median
$10.72
Typical High
$11.22
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$8.13
Median
$10.72
Typical High
$12.88
United
Setting
Facility
Modifier
Global
Typical Low
$4.17
Median
$4.79
Typical High
$6.17
United
Setting
Professional
Modifier
Global
Typical Low
$4.17
Median
$5.25
Typical High
$7.94