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Arkansas rates for HCPCS A4422

Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.13 / $0.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.08 / $0.10