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South Dakota rates for HCPCS A4455

Adhesive remover or solvent (for tape, cement or other adhesive), per oz

Facilitymedian $2 · 10th–90th $1–$30%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $2.51 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.86 / $1.86 / $2.34
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $2.00 / $2.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.85 / $10.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $2.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.82 / $1.82 / $3.55
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $2.00 / $2.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.66 / $1.00 / $1.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.78 / $1.78 / $1.78