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South Dakota rates for HCPCS A4244

Alcohol Or Peroxide Per Pint (Not Valid For Medicare)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.46 / $0.46 / $0.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.94 / $0.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.79 / $1.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.36 / $0.72 / $7.07
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.91 / $1.12 / $1.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.91 / $1.10 / $1.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.57 / $0.75
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.64 / $2.64 / $2.64