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Utah rates for HCPCS A4417

Ostomy Pouch Closed With Barrier Attached With Built-In Convexity With Filter (1 Piece) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $2.78 / $15.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.13 / $3.13 / $3.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.13 / $6.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.11 / $3.80 / $4.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.89 / $3.65 / $5.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $2.21 / $2.47