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California 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
$0.05 / $0.05 / $0.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.08 / $0.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.14
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.18 / $0.23 / $0.36
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.33 / $0.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.12
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.11 / $0.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $3.54 / $3.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.15 / $0.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.14
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.27 / $0.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.14