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Utah rates for HCPCS A5131

Appliance Cleaner Incontinence And Ostomy Appliances Per 16 Oz. (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.07 / $6.07 / $6.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.07 / $11.80 / $63.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.92 / $13.30 / $13.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.31 / $13.30 / $21.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.25 / $16.17 / $21.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.32 / $15.51 / $23.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.52 / $8.61 / $9.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.36 / $9.39 / $13.48