go back

South Dakota rates for HCPCS A4395

Ostomy deodorant for use in ostomy pouch, solid, per tablet

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.07 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.04 / $0.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.12
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.05
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05