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South Dakota rates for HCPCS A4652

Microcapillary Tube Sealant (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.20 / $0.20 / $0.33