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Utah rates for HCPCS A4364

Adhesive, liquid or equal, any type, per oz

Facilitymedian $1 · 10th–90th $1–$10%50%100%$1Professionalmedian $2 · 10th–90th $1–$50%20%10th90th$2$1.0$2.0$5.0$10.0$20.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.09 / $2.09 / $2.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $3.63 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.95 / $2.95
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $4.07 / $9.12
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.17 / $5.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.74 / $2.63