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Utah rates for HCPCS A4433

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

Facilitymedian $1 · 10th–90th $1–$30%50%90th$1Professionalmedian $3 · 10th–90th $1–$200%10%20%10th90th$3$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 / $3.02 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $2.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.40 / $3.31
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $3.39 / $4.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $3.39 / $5.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.68 / $4.68 / $4.79
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $4.79 / $5.75
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $1.82 / $2.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $2.00 / $3.89