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South Dakota rates for HCPCS A4231

Infusion Set For External Insulin Pump Needle Type (Special Coverage Instructions Apply. See Cim: 60-14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.49 / $28.49 / $28.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.65 / $27.20 / $28.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.50 / $15.50 / $19.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.50 / $10.50 / $13.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.39 / $38.52 / $48.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.73 / $103.73 / $103.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.34 / $10.75 / $10.75
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.39 / $10.75 / $12.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.22 / $24.22 / $24.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.50 / $10.50 / $10.50