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Minnesota 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 / $0.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.17 / $1.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $1.03 / $2.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.40 / $0.48
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.98 / $2.25
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.15 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.19