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Kentucky 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
$0.06 / $0.08 / $0.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.22 / $0.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.19 / $0.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $45.00 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.08 / $0.11