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South Dakota rates for HCPCS A4405

Ostomy Skin Barrier Non-Pectin Based Paste Per Ounce

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.04 / $3.04 / $3.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $3.26 / $4.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.86 / $3.03 / $5.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.63 / $5.63 / $7.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.26 / $5.51 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.90 / $2.89 / $5.45
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.37 / $5.25 / $6.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $5.32 / $10.02
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $4.66 / $5.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $2.38 / $4.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.29 / $4.29 / $4.29