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Wisconsin 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%40%10th90th$0Professionalmedian $0 · 10th–90th $0–$10%20%40%10th90th$0$0.1$0.2$1.0$5.0$20.0$100.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.14 / $0.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $1.05 / $1.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.25 / $0.47
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.13 / $0.23
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.35 / $0.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.15 / $79.43
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.07 / $0.08 / $0.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.27 / $0.27 / $0.27
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.17 / $0.30
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.37 / $1.05
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.09 / $0.30 / $79.43
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.08 / $0.15 / $3.72
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.06 / $0.07 / $0.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.08 / $0.13