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Ostomy Absorbent Material to Thicken Stomal Output

New Hampshire rates for HCPCS A4422

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

Rates data updated July 2026.

Facilitymedian $0 · 10th–90th $0$00%50%10th90th$0Professionalmedian $0 · 10th–90th $0$00%20%10th90th$0$0.1$0.1$0.2$0.5

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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.09
Median
$0.09
Typical High
$0.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.07
Median
$0.09
Typical High
$0.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.08
Typical High
$0.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.09
Median
$0.09
Typical High
$0.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.08
Typical High
$0.11
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$0.13
Median
$0.13
Typical High
$0.24
United
Setting
Facility
Modifier
Global
Typical Low
$0.04
Median
$0.06
Typical High
$0.07
United
Setting
Professional
Modifier
Global
Typical Low
$0.06
Median
$0.10
Typical High
$0.13
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$0.33
Median
$0.33
Typical High
$0.33