go back

Utah rates for HCPCS A4393

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.46 / $3.46 / $3.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.46 / $6.73 / $36.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $8.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.45 / $7.59 / $14.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.01 / $9.22 / $12.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.03 / $8.84 / $13.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.19 / $5.36 / $6.29