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Utah rates for HCPCS A4361

Ostomy Faceplate Each (Special Coverage Instructions Apply. See Mcm: 2130a)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.02 / $7.02 / $7.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $11.63 / $74.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.42 / $15.42 / $15.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.11 / $15.42 / $29.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.35 / $18.80 / $25.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.27 / $17.96 / $26.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.52 / $10.88 / $10.88