go back

Utah rates for HCPCS A5071

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.29 / $2.29 / $2.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.29 / $4.47 / $24.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.04 / $5.04 / $5.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.28 / $5.04 / $9.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.02 / $6.15 / $8.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.67 / $5.88 / $8.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.79 / $3.56 / $4.18