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South Dakota rates for HCPCS A4562

Pessary, reusable, non rubber, any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $54.95 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $102.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $75.86 / $134.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $45.71 / $354.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $77.62 / $77.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $128.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $72.44 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $35.48 / $72.44
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $63.10