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Illinois rates for HCPCS A4422

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

Facilitymedian $1 · 10th–90th $0–$70%10%10th90th$1Professionalmedian $0 · 10th–90th $0–$10%10%20%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.81 / $1.66 / $6.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.09 / $0.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.33
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.28 / $0.38
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.20 / $0.20 / $0.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.05 / $0.06 / $0.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.08 / $0.12