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South Dakota rates for HCPCS A4387

Ostomy pouch, closed, with barrier attached, with built-in convexity (one piece), each

Facilitymedian $2 · 10th–90th $2–$40%20%40%10th90th$2Professionalmedian $2 · 10th–90th $1–$50%20%40%10th90th$2$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $2.00 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $3.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.72 / $3.72 / $4.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.95 / $3.47 / $5.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $2.24 / $15.49
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $3.47 / $3.47
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.55 / $3.55 / $3.55
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $2.88 / $5.62
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.63 / $3.16 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $2.24 / $3.98
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.82 / $2.82 / $2.82