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Utah rates for HCPCS A4435

Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

Facilitymedian $2 · 10th–90th $2–$50%50%90th$2Professionalmedian $6 · 10th–90th $2–$350%10%20%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 / $5.01 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $4.79 / $4.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $4.07 / $5.75
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $5.89 / $7.94
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $9.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $8.13 / $9.77
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.69 / $3.09 / $3.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.69 / $3.39 / $6.17