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New Jersey 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
$0.08 / $0.08 / $0.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.08 / $0.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.33
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.15 / $0.20
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.10 / $0.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.08 / $0.13