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South Dakota rates for HCPCS A4384

Ostomy Faceplate Equivalent Silicone Ring Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.56 / $8.56 / $8.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.56 / $9.18 / $11.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.07 / $8.07 / $14.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.38 / $15.38 / $19.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.19 / $15.51 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.35 / $8.18 / $15.35
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.29 / $14.76 / $19.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.57 / $14.98 / $28.24
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.20 / $13.11 / $15.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $6.70 / $11.17
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.08 / $12.08 / $12.08