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Utah rates for HCPCS A4363

Ostomy clamp, any type, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $14.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $1.70 / $2.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.86 / $2.24 / $3.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.69 / $4.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.19 / $3.31
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $3.09 / $3.39
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.24 / $3.16 / $4.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.29 / $1.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.41 / $2.00