go back

Utah rates for HCPCS A4392

Ostomy Pouch Urinary With Standard Wear Barrier Attached With Built-In Convexity (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.13 / $6.09 / $32.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.86 / $6.86 / $7.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $6.86 / $13.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $8.34 / $10.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.36 / $7.99 / $11.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.70 / $4.84 / $6.54