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Utah rates for HCPCS A5073

Ostomy pouch, urinary; for use on barrier with flange (two piece), each

Facilitymedian $1 · 10th–90th $1–$30%50%90th$1Professionalmedian $3 · 10th–90th $1–$190%10%10th90th$3$0.1$0.2$1.0$5.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.82 / $19.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.69 / $2.69 / $2.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $3.39
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $3.16 / $5.01
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $3.09 / $4.90
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.17 / $4.37 / $4.47
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.31 / $4.47 / $5.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.70 / $2.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.86 / $3.39