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South Dakota rates for HCPCS A4616

Tubing (oxygen), per foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.06 / $0.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.06 / $0.06 / $0.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.38 / $0.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.07 / $0.10 / $90.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.05 / $0.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.09 / $0.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.07 / $0.08 / $0.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.07
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.08