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Utah rates for HCPCS A4404

Ostomy Ring Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.65 / $0.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $1.25 / $6.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.41 / $2.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.40 / $1.71 / $2.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.64 / $2.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $1.00 / $1.19