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Utah rates for HCPCS A4392

Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (one piece), each

Facilitymedian $3 · 10th–90th $3–$70%50%90th$3Professionalmedian $8 · 10th–90th $3–$500%10%10th90th$8$0.1$0.5$2.0$10.0$50.0

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
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $7.41 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $5.89 / $8.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $8.32 / $11.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $12.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $11.48 / $11.75
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $11.75 / $14.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.80 / $4.37 / $4.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $4.79 / $8.71