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South Dakota rates for HCPCS A4376

Ostomy pouch, drainable, with faceplate attached, rubber, each

Facilitymedian $48 · 10th–90th $42–$830%20%40%10th90th$48Professionalmedian $52 · 10th–90th $37–$950%10%20%10th90th$52$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $42.66 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $95.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $72.44 / $125.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $42.66 / $331.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $72.44
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $120.23
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $44.67 / $77.62
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26