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North Dakota 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
$0.11 / $0.11 / $0.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.10 / $0.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.17 / $0.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.38 / $0.38 / $0.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $0.11 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.07 / $0.15