go back

North Carolina 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
$0.14 / $0.14 / $0.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.14 / $0.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.20 / $0.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.10 / $0.11 / $0.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.14 / $0.37
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.12
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $3.68 / $3.68