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South Dakota rates for HCPCS A4416

Ostomy pouch, closed, with barrier attached, with filter (one piece), each

Facilitymedian $3 · 10th–90th $2–$50%20%40%10th90th$3Professionalmedian $3 · 10th–90th $2–$60%20%40%10th90th$3$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $5.01
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.89 / $3.89 / $3.89
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.07 / $4.07 / $4.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.29 / $2.29 / $4.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $4.47 / $5.62
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $4.17 / $7.24
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $2.45 / $19.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $4.27 / $4.27
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $4.37 / $4.37
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.55 / $3.55 / $6.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.89 / $5.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $2.57 / $4.47
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $3.47 / $3.47