go back

South Dakota rates for HCPCS A4311

Insertion Tray Without Drainage Bag With Indwelling Catheter Foley Type Two-Way Latex With Coating (Teflon Silicone Silicone Elastomer Or Hydrophilic Etc.) (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.20 / $13.20 / $13.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.20 / $14.15 / $14.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.94 / $12.44 / $19.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.00 / $24.00 / $30.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.33 / $23.91 / $92.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.25 / $14.63 / $20.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.09 / $19.68 / $29.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.67 / $20.02 / $37.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.28 / $20.21 / $24.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.87 / $14.63 / $17.21
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.84 / $15.84 / $15.84