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South Dakota rates for HCPCS A4388

Ostomy Pouch Drainable With Extended Wear Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $3.89 / $3.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.89 / $4.17 / $5.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $3.88 / $6.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.13 / $7.13 / $8.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $7.05 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.43 / $3.71 / $6.97
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.58 / $6.70 / $8.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.26 / $6.80 / $12.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.09 / $5.95 / $7.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.02 / $3.04 / $5.07
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.48 / $5.48 / $5.48