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South Dakota rates for HCPCS A4373

Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $5.01 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.62 / $9.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $10.23 / $12.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $9.55 / $16.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $5.01 / $43.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $9.55 / $9.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $9.77 / $9.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $15.85
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $8.71 / $11.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $4.37 / $8.91
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $7.94