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Texas rates for HCPCS A4422

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

Facilitymedian $0 · 10th–90th $0–$00%20%10th90th$0Professionalmedian $0 · 10th–90th $0–$00%50%10th90th$0$0.1$0.5$5.0$50.0$500.0

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.08 / $0.09 / $0.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.09
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.09 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.09
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $1.12 / $3.72
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.08 / $0.14 / $0.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.13 / $0.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $2,754.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.08 / $0.14 / $0.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.08 / $0.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $0.07 / $0.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.08 / $0.10
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.15 / $0.15