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Utah rates for HCPCS A4358

Urinary Drainage Bag Leg Or Abdomen Vinyl With Or Without Tube With Straps Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.54 / $2.54 / $2.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.54 / $5.09 / $26.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $5.57 / $5.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $5.57 / $10.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.22 / $6.68 / $8.72
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.08 / $6.41 / $9.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.08 / $3.93 / $4.61