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Utah rates for HCPCS A4355

Irrigation Tubing Set For Continuous Bladder Irrigation Through A Three-Way Indwelling Foley Catheter Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.41 / $3.41 / $3.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.41 / $6.57 / $35.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $6.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $8.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.33 / $7.76 / $10.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $7.41 / $11.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $5.29 / $6.20