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Utah rates for HCPCS A4625

Tracheostomy care kit for new tracheostomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $6.03 / $37.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $5.75 / $5.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $6.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $7.08 / $9.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $6.92 / $9.33
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $9.77 / $9.77
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $9.77 / $10.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.24 / $3.80 / $6.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $4.07 / $5.89