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Utah rates for HCPCS A4430

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $6.34 / $34.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.15 / $7.15 / $7.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.08 / $7.15 / $13.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $8.69 / $11.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.62 / $8.33 / $12.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.95 / $5.05 / $6.07