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South Dakota rates for HCPCS A4360

Disposable external urethral clamp or compression device, with pad and/or pouch, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.44 / $0.44 / $0.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.75 / $0.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.61 / $0.73 / $0.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.54 / $3.87
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.71 / $0.79 / $0.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.73 / $1.10
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.56 / $0.69 / $0.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.34 / $0.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $0.59 / $0.59