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South Dakota rates for HCPCS A4615

Cannula Nasal (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 3312)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.65 / $0.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.70 / $0.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $0.76 / $1.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $1.18 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.41 / $0.54 / $1.10
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.12 / $1.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.87 / $1.12 / $1.70
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.84 / $1.00 / $1.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.34 / $0.51 / $0.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.97 / $0.97 / $0.97