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Montana rates for HCPCS A4422

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

Facilitymedian $0 · 10th–90th $0–$00%50%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%10th90th$0$0.1$0.5$2.0$10.0$50.0

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
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.16 / $0.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.16 / $0.16
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.28
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.15 / $0.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.07 / $0.15 / $0.21
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.16 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $0.06 / $0.06
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.07 / $0.10