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Utah rates for HCPCS A4380

Ostomy pouch, urinary, with faceplate attached, rubber, each

Facilitymedian $14 · 10th–90th $14–$350%50%90th$14Professionalmedian $37 · 10th–90th $14–$2290%10%10th90th$37$0.5$2.0$10.0$50.0$200.0

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
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $33.88 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $29.51 / $34.67
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $48.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $58.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $52.48 / $53.70
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $53.70 / $64.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $19.95 / $21.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $21.88 / $39.81