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Utah rates for HCPCS A4373

Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, 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
$2.00 / $5.01 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.25 / $5.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $4.47 / $6.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.46 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $6.31 / $9.33
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $8.71 / $8.91
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $8.91 / $10.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.95 / $3.39 / $4.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.88 / $3.72 / $5.37