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Georgia 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
$0.10 / $0.10 / $0.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.10 / $0.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.13 / $0.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.15 / $0.28
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.15 / $0.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.08 / $0.14