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South Dakota rates for HCPCS A4392

Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (one piece), each

Facilitymedian $8 · 10th–90th $7–$140%20%40%10th90th$8Professionalmedian $9 · 10th–90th $6–$170%20%10th90th$9$5.0$10.0$20.0$50.0

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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.08 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $6.92 / $12.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $13.18 / $16.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $12.30 / $21.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.57 / $7.24 / $56.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $12.59 / $12.59
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $12.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $20.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $11.48 / $15.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.80 / $7.59 / $13.49
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23