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South Dakota rates for HCPCS A4312

Insertion Tray Without Drainage Bag With Indwelling Catheter Foley Type Two-Way All Silicone (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.07 / $16.07 / $16.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.32 / $16.07 / $21.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.09 / $15.15 / $27.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.72 / $29.25 / $36.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $27.56 / $113.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.93 / $17.82 / $28.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.06 / $27.72 / $36.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.69 / $28.11 / $52.97
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.69 / $21.89 / $26.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.36 / $12.58 / $18.98
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.68 / $22.68 / $22.68