go back

South Dakota rates for HCPCS A5051

Ostomy Pouch Closed; With Barrier Attached (1 Piece) Each (Updated 01-01-2003)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.84 / $1.84 / $1.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.84 / $1.97 / $2.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.73 / $1.73 / $3.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $3.38 / $4.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.98 / $3.33 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $1.76 / $3.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.64 / $3.17 / $4.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $3.22 / $6.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.81 / $3.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.44 / $2.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.59 / $2.59 / $2.59