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South Dakota rates for HCPCS A4634

Replacement bulb for therapeutic light box, tabletop model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.00 / $157.00 / $157.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $157.00 / $157.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.50 / $50.50 / $63.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.75 / $33.75 / $42.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.53 / $35.06 / $265.33