go back

South Dakota rates for HCPCS A6021

Collagen Dressing Sterile Size 16 Sq. In. Or Less Each (Revised 01/01/13)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.73 / $18.73 / $18.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.61 / $10.08 / $20.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.00 / $44.00 / $55.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.13 / $34.13 / $42.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.48 / $31.95 / $40.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.70 / $23.40 / $146.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.22 / $33.46 / $42.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.86 / $32.32 / $49.43
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.50 / $29.38 / $38.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.76 / $14.65 / $27.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.44 / $26.44 / $26.44