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South Dakota rates for HCPCS A5122

Skin barrier; solid, 8 x 8 or equivalent, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.04 / $11.04 / $11.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.04 / $12.26 / $15.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.78 / $10.78 / $19.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.25 / $20.25 / $25.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.28 / $20.72 / $80.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $10.92 / $20.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.41 / $19.73 / $25.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.45 / $20.02 / $37.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.97 / $17.52 / $20.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.96 / $8.94 / $14.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.14 / $16.14 / $16.14