go back

Utah rates for HCPCS A4407

Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 in or smaller, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $7.08 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.41 / $7.41 / $7.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $6.31 / $8.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $8.91 / $12.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $8.71 / $13.18
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $12.30 / $12.59
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $12.59 / $15.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $4.68 / $5.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $5.25 / $7.41