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South Dakota rates for HCPCS A4301

Implantable Access Total Catheter Port/Reservoir (E.G. Venous Arterial Epidural Or Subarachnoid Peritoneal Etc.) (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.49 / $34.49 / $34.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.33 / $34.49 / $34.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $2.02 / $139.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.65 / $56.33 / $91.32
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.69 / $139.69 / $139.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.87 / $139.69 / $139.69