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South Dakota rates for HCPCS A4428

Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (one piece), each

Facilitymedian $6 · 10th–90th $5–$110%20%40%10th90th$6Professionalmedian $7 · 10th–90th $5–$130%20%10th90th$7$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
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $13.18
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $10.00 / $16.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.63 / $5.75 / $45.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $10.00 / $10.00
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $16.22
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $9.12 / $12.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $6.03 / $10.72
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13