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Utah rates for HCPCS A4423

Ostomy pouch, closed; for use on barrier with locking flange, with filter (two piece), each

Facilitymedian $1 · 10th–90th $1–$20%20%40%10th90th$1Professionalmedian $2 · 10th–90th $1–$110%20%10th90th$2$0.0$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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $11.22
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.55 / $1.55 / $1.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $1.91 / $2.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $2.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.57 / $2.63
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.63 / $3.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.87 / $1.00 / $1.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.85 / $1.10 / $2.00