go back

Utah rates for HCPCS A4384

Ostomy Faceplate Equivalent Silicone Ring Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.68 / $3.68 / $3.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.68 / $7.16 / $38.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $8.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.86 / $8.07 / $15.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.39 / $9.80 / $12.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.47 / $9.39 / $14.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $5.22 / $5.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $5.69 / $6.85