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Utah rates for HCPCS A4388

Ostomy pouch, drainable, with extended wear barrier attached, (one piece), each

Facilitymedian $1 · 10th–90th $1–$40%50%90th$1Professionalmedian $4 · 10th–90th $1–$260%10%10th90th$4$0.1$0.2$1.0$5.0$20.0

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 / $3.89 / $26.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.63 / $3.63 / $3.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.09 / $4.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $4.47 / $6.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $6.76
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.62 / $6.03 / $6.17
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $6.17 / $7.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.04 / $2.34 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.57 / $5.01