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South Dakota rates for HCPCS A5061

Ostomy pouch, drainable; with barrier attached, (one piece), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.15 / $3.15 / $3.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $3.37 / $4.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.97 / $3.14 / $5.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.63 / $5.63 / $7.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.37 / $5.70 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.97 / $2.99 / $5.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.51 / $5.43 / $7.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.24 / $5.50 / $10.35
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.12 / $4.82 / $5.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.64 / $2.46 / $4.09
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.45 / $4.45 / $4.45