go back

Utah rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Facilitymedian $2 · 10th–90th $2–$50%50%90th$2Professionalmedian $6 · 10th–90th $2–$400%10%10th90th$6$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
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $5.89 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $5.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $6.46
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $6.61 / $8.91
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.46 / $6.46 / $10.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $9.12 / $9.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $9.33 / $11.22
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.09 / $3.55 / $3.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.89 / $7.41