go back

Utah rates for HCPCS A4562

Pessary, reusable, non rubber, any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $154.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $70.79 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $57.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $52.48 / $67.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $51.29 / $74.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $72.44 / $74.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $74.13 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $28.84 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.55 / $31.62 / $45.71