go back

Utah rates for HCPCS A4423

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $1.38 / $7.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.56 / $1.56 / $1.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.33 / $1.56 / $3.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.89 / $2.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.81 / $2.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.86 / $1.10 / $1.10