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South Dakota rates for HCPCS A4328

Female External Urinary Collection Device; Pouch Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.02 / $9.02 / $9.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.02 / $9.02 / $9.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.00 / $21.00 / $26.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.04 / $16.50 / $20.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.65 / $15.88 / $19.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.81 / $11.62 / $72.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.94 / $16.63 / $20.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.34 / $16.04 / $22.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.17 / $15.51 / $19.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.84 / $9.30 / $18.66
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.12 / $13.12 / $13.12