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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
$10.96 / $10.96 / $10.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.00 / $15.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $20.42 / $25.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.30 / $19.05 / $33.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $10.23 / $89.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $19.50 / $19.95
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $16.60 / $32.36
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $17.78 / $23.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $8.91 / $17.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $16.22 / $16.22