go back

South Dakota rates for HCPCS A4561

Pessary Reusable Rubber Any Type (Desc Rsvd 4/1/2024)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.26 / $18.26 / $18.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.82 / $9.69 / $23.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.30 / $31.30 / $31.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.38 / $33.71 / $41.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.44 / $33.34 / $122.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.51 / $18.41 / $32.52
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.02 / $31.30 / $49.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.63 / $31.72 / $59.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.09 / $28.19 / $33.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.98 / $14.40 / $24.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.61 / $25.61 / $25.61