go back

Utah rates for HCPCS A4426

Ostomy pouch, drainable; for use on barrier with locking flange (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.04 / $1.04 / $1.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.04 / $2.02 / $11.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.95 / $2.29 / $4.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.78 / $3.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.67 / $4.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.61 / $1.90