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South Dakota rates for HCPCS A4363

Ostomy clamp, any type, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.93 / $2.11 / $2.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.99 / $2.11 / $3.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.75 / $4.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.25 / $3.26 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.79 / $3.78
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.03 / $3.14 / $4.76
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.52 / $3.14 / $5.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $2.75 / $3.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.10 / $1.40 / $2.50
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $2.98 / $2.98