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Adhesive or Nonadhesive Disk or Foam Pad

Utah rates for HCPCS A5126

Adhesive or nonadhesive; disk or foam pad

Rates data updated July 2026.

How much does Adhesive or Nonadhesive Disk or Foam Pad cost?

$1.32

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $1.32 for this service. The price depends on where it is billed: about $1.32 from a physician practice, and about $0.50 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1.32$0.93 to $1.86
FacilityA hospital or hospital-owned outpatient department$0.50$0.50 to $0.62

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $1 to $7
$1$2$5facility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.50
Median
$0.50
Typical High
$0.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.50
Median
$1.17
Typical High
$6.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.10
Median
$1.10
Typical High
$1.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.93
Median
$0.93
Typical High
$1.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$0.93
Median
$1.51
Typical High
$2.09
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1.02
Median
$1.32
Typical High
$1.86
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$1.86
Typical High
$1.86
Select Health
Setting
Professional
Modifier
Global
Typical Low
$0.93
Median
$1.78
Typical High
$1.86
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.41
Median
$1.86
Typical High
$1.91
United
Setting
Facility
Modifier
Global
Typical Low
$0.62
Median
$0.71
Typical High
$0.78
United
Setting
Professional
Modifier
Global
Typical Low
$0.62
Median
$0.78
Typical High
$1.17

Where Utah sits

The same service costs 3.3 times more in Kansas than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 15th of 51

$1.32

KS $2.63CO $0.79

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.