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South Dakota rates for HCPCS A4331

Extension Drainage Tubing Any Type Any Length With Connector/Adaptor For Use With Urinary Leg Bag Or Urostomy Pouch Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.83 / $2.83 / $2.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.83 / $2.83 / $3.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.50 / $6.50 / $8.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $5.25 / $6.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.16 / $4.83 / $6.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $3.54 / $22.11
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.87 / $5.07 / $6.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.88 / $7.48
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.71 / $4.44 / $5.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.48 / $2.21 / $3.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.00 / $4.00 / $4.00