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South Dakota rates for HCPCS A4322

Irrigation Syringe Bulb Or Piston Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.50 / $6.50 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $4.88 / $6.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.90 / $4.62 / $5.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.70 / $3.39 / $22.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.67 / $4.84 / $6.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.69 / $7.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $4.26 / $5.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $2.12 / $3.73
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.83 / $3.83 / $3.83