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South Dakota rates for HCPCS A4409

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 in or smaller, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.34 / $5.01 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.25 / $5.50 / $9.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $10.23 / $12.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $9.55 / $16.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $5.50 / $43.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $9.55 / $9.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $9.77 / $9.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $15.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $8.71 / $11.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $4.37 / $8.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76