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South Dakota rates for HCPCS A4434

Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (two piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.35 / $3.35 / $3.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.35 / $3.59 / $4.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.51 / $3.51 / $5.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $6.00 / $7.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.58 / $6.07 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.09 / $3.20 / $6.01
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $5.78 / $7.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $5.85 / $11.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.38 / $5.13 / $6.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $2.47 / $4.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.73 / $4.73 / $4.73