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South Dakota rates for HCPCS A4225

Supplies For External Insulin Infusion Pump Syringe Type Cartridge Sterile Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.20 / $2.20 / $2.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.00 / $5.00 / $6.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $3.75 / $4.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $4.04 / $4.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $2.60 / $16.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.64 / $3.99 / $5.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.19 / $3.86 / $5.04
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $3.80 / $4.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.70 / $2.83
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.16 / $3.16 / $3.16