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Ostomy Absorbent Material to Thicken Stomal Output

South Dakota 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%20%10th90th$0Professionalmedian $0 · 10th–90th $0$00%20%10th90th$0$0.1$0.5$2.0$10.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.11
Median
$0.11
Typical High
$0.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.10
Median
$0.11
Typical High
$0.22
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.09
Median
$0.09
Typical High
$0.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.38
Median
$0.38
Typical High
$0.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.11
Median
$0.17
Typical High
$0.30
Medica
Setting
Professional
Modifier
Global
Typical Low
$0.07
Median
$0.10
Typical High
$3.55
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.14
Median
$0.17
Typical High
$0.17
Midlands
Setting
Professional
Modifier
Global
Typical Low
$0.14
Median
$0.14
Typical High
$0.28
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$0.14
Median
$0.15
Typical High
$0.20
United
Setting
Facility
Modifier
Global
Typical Low
$0.06
Median
$0.08
Typical High
$0.11
United
Setting
Professional
Modifier
Global
Typical Low
$0.05
Median
$0.10
Typical High
$0.17
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$0.12
Median
$0.12
Typical High
$0.12