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Utah rates for HCPCS A4413

Ostomy pouch, drainable, high output, for use on a barrier with flange (two-piece system), with filter, each

Facilitymedian $2 · 10th–90th $2–$50%50%90th$2Professionalmedian $5 · 10th–90th $2–$330%10%10th90th$5$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
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $4.90 / $33.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.57 / $4.57 / $4.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $5.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.89 / $5.62 / $7.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $8.71
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.76 / $7.76
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $7.76 / $9.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $2.95 / $3.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.57 / $3.24 / $5.89