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Utah rates for HCPCS A5073

Ostomy Pouch Urinary; For Use On Barrier With Flange (2 Piece) Each (Updated 01-01-2003) Cm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.22 / $1.22 / $1.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.22 / $2.37 / $12.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.67 / $2.67 / $3.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $5.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $3.18 / $4.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.42 / $3.04 / $4.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $1.88 / $2.21