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Utah rates for HCPCS A5051

Ostomy Pouch Closed; With Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $2.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $1.73 / $1.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.47 / $1.73 / $3.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.10 / $2.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $2.02 / $3.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.22 / $2.16