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South Dakota rates for HCPCS A4280

Adhesive Skin Support Attachment For Use With External Breast Prosthesis Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.75 / $4.75 / $4.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.75 / $4.75 / $5.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.00 / $11.00 / $13.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.63 / $8.63 / $10.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $7.95 / $10.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $5.95 / $37.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.00 / $14.37 / $14.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.65 / $7.66 / $12.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.23 / $7.49 / $9.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.61 / $3.73 / $6.22
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.22 / $7.22 / $7.22