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South Dakota rates for HCPCS A4420

Ostomy pouch, closed; for use on barrier with locking flange (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.68 / $0.68 / $0.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.02 / $2.02 / $2.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.72 / $2.02 / $2.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.97 / $1.14 / $1.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $2.40 / $2.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.00 / $2.00