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South Dakota rates for HCPCS A4550

Surgical Trays

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $12.88 / $22.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $22.91 / $28.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $23.44 / $54.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $11.75 / $154.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $32.36 / $32.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $47.86
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $13.18 / $13.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $11.48 / $23.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66