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Utah rates for HCPCS A5081

Stoma Plug Or Seal Any Type Revised 1/1/2014

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $2.47 / $13.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.60 / $2.60 / $2.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.89 / $2.21 / $3.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $2.88 / $4.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.18 / $2.76 / $4.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.54 / $1.96 / $2.20