go back

Hawaii 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
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.13 / $0.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.17
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.16 / $0.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.15 / $0.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.12 / $0.15
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.13 / $0.15