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South Dakota rates for HCPCS A4357

Bedside Drainage Bag Day Or Night With Or Without Anti-Reflux Device With Or Without Tube Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.65 / $8.65 / $8.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $9.27 / $10.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.40 / $8.15 / $14.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.75 / $15.75 / $19.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $14.74 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.41 / $9.59 / $14.57
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.66 / $14.53 / $19.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.66 / $14.77 / $27.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.31 / $13.25 / $15.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $6.77 / $11.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $11.48