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Utah rates for HCPCS A4424

Ostomy pouch, drainable, with barrier attached, with filter (one piece), each

Facilitymedian $1 · 10th–90th $1–$40%50%90th$1Professionalmedian $4 · 10th–90th $1–$290%10%20%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 / $3.98 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $3.39 / $4.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $4.79 / $6.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $4.79 / $7.41
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $6.61 / $6.76
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.13 / $6.76 / $8.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.57 / $2.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.82 / $5.13