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Utah rates for HCPCS A4425

Ostomy Pouch Drainable; For Use On Barrier With Non-Locking Flange With Filter (2 Piece System) Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.37 / $1.37 / $1.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.67 / $14.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.01 / $3.01 / $3.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.56 / $5.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.99 / $3.65 / $4.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $3.50 / $5.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.66 / $2.12 / $2.49