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Utah rates for HCPCS A4416

Ostomy Pouch Closed With Barrier Attached With Filter (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.05 / $1.05 / $1.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $2.04 / $11.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.96 / $2.31 / $4.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.30 / $2.81 / $3.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.70 / $4.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.28 / $1.63 / $1.92