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South Dakota rates for HCPCS A4424

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.24 / $4.24 / $4.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $4.54 / $5.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.00 / $4.23 / $7.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.88 / $7.88 / $9.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.54 / $7.67 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.65 / $4.04 / $7.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.08 / $7.32 / $9.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.72 / $7.42 / $13.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.54 / $6.49 / $7.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.35 / $4.42 / $6.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.99 / $5.99 / $5.99