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South Dakota rates for HCPCS A6204

Composite dressing, sterile, pad size more than 16 sq in, but less than or equal to 48 sq in, with any size adhesive border, each dressing

Facilitymedian $8 · 10th–90th $5–$130%20%10th90th$8Professionalmedian $5 · 10th–90th $4–$110%20%10th90th$5$5.0$10.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.98 / $5.01 / $10.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $16.22
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $12.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $8.71 / $11.75
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $3.72 / $43.65
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $9.55
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $15.49
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.71 / $11.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.88 / $4.37 / $9.77
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $7.76