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South Dakota rates for HCPCS A4413

Ostomy Pouch Drainable High Output For Use On A Barrier With Flange (2 Piece System) With Filter Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.91 / $4.91 / $4.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.91 / $5.26 / $6.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.62 / $5.71 / $8.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.00 / $9.00 / $11.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.26 / $8.89 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $4.68 / $8.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.04 / $8.47 / $11.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.62 / $8.58 / $16.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.42 / $7.52 / $8.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $3.84 / $6.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.93 / $6.93 / $6.93