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Ostomy Absorbent Material to Thicken Stomal Output

Texas 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$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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$0.10
Typical High
$0.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.10
Typical High
$0.14
BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$0.09
Typical High
$0.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.08
Typical High
$0.09
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$0.10
Median
$0.13
Typical High
$0.21
Christus
Setting
Facility
Modifier
Global
Typical Low
$0.15
Median
$0.15
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$0.09
Median
$0.09
Typical High
$0.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.08
Typical High
$0.09
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$85.11
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$3.72
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$0.14
Typical High
$0.24
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$0.06
Median
$0.13
Typical High
$0.17
Molina
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$2,754.23
Providence
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$0.13
Typical High
$0.24
Providence
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.08
Typical High
$0.09
United
Setting
Facility
Modifier
Global
Typical Low
$0.06
Median
$0.08
Typical High
$0.15
United
Setting
Professional
Modifier
Global
Typical Low
$0.06
Median
$0.08
Typical High
$0.10
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$0.08
Median
$0.15
Typical High
$0.20