go back

South Dakota rates for HCPCS A4415

Ostomy Skin Barrier With Flange (Solid Flexible Or Accordion) Extended Wear Without Built-In Convexity Larger Than 4 X 4 Inches Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.34 / $5.34 / $5.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.34 / $5.73 / $7.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.03 / $5.33 / $9.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.75 / $9.75 / $12.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.73 / $9.68 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $5.09 / $9.57
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.66 / $9.22 / $12.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.21 / $9.34 / $17.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.98 / $8.18 / $9.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.78 / $4.18 / $11.06
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.54 / $7.54 / $7.54