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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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.45 / $0.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.16 / $0.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.16 / $0.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.15 / $0.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.13 / $0.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.07 / $0.11