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Utah rates for HCPCS A5056

Ostomy pouch, drainable, with extended wear barrier attached, with filter, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.34 / $2.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $3.60 / $18.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.93 / $3.93 / $4.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $3.93 / $7.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $4.76 / $6.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.63 / $4.57 / $6.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.77 / $3.25