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South Dakota rates for HCPCS A4427

Ostomy pouch, drainable; for use on barrier with locking flange, with filter (two-piece system), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.49 / $2.49 / $2.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $2.67 / $3.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.34 / $2.50 / $4.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.50 / $4.50 / $5.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.66 / $4.51 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.55 / $2.36 / $4.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.55 / $4.29 / $5.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.34 / $4.34 / $8.16
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $3.81 / $4.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.30 / $1.94 / $3.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.51 / $3.51 / $3.51