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South Dakota rates for HCPCS A4354

Insertion tray with drainage bag but without catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $10.00 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $24.55 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.05 / $23.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $16.22 / $21.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $8.13 / $109.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $18.20 / $18.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $15.14 / $28.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $16.22 / $21.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $6.92 / $16.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $14.79 / $14.79