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Utah rates for HCPCS A4417

Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (one piece), each

Facilitymedian $1 · 10th–90th $1–$30%50%90th$1Professionalmedian $4 · 10th–90th $1–$230%10%10th90th$4$0.1$0.2$1.0$5.0$20.0

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
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $3.02 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.09 / $3.80 / $5.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $5.89
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $5.25 / $5.37
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.37 / $6.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $2.00 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.74 / $2.19 / $3.98