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Utah rates for HCPCS A4367

Ostomy belt, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $6.03 / $42.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $6.17 / $6.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $7.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $8.32 / $32.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $7.41 / $10.47
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $10.23 / $10.47
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $10.47 / $11.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.47 / $3.98 / $4.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $4.37 / $6.31