go back

South Dakota rates for HCPCS A4369

Ostomy skin barrier, liquid (spray, brush, etc.), per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.95 / $1.97 / $2.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.80 / $2.04 / $3.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.69 / $3.75 / $4.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.97 / $3.33 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.84 / $3.42
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.64 / $3.18 / $4.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $3.22 / $6.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.81 / $3.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.44 / $2.54
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.59 / $2.59