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South Dakota rates for HCPCS A6215

Foam dressing, wound filler, sterile, per g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.04 / $4.04 / $4.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.86 / $4.04 / $4.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.00 / $15.00 / $18.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.13 / $10.13 / $12.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.83 / $6.73 / $8.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.63 / $12.63 / $12.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.32 / $12.63 / $12.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.60 / $3.60 / $3.60