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Utah rates for HCPCS A4415

Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 in, each

Facilitymedian $2 · 10th–90th $2–$50%50%90th$2Professionalmedian $6 · 10th–90th $2–$360%10%10th90th$6$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 / $5.37 / $36.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $4.27 / $5.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $6.17 / $8.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $9.33
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $8.32 / $8.51
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $8.51 / $10.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.82 / $3.24 / $4.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.75 / $3.55 / $6.46