go back

South Dakota rates for HCPCS A6220

Gauze Non-Impregnated Pad Size More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. With Any Size Adhesive Border Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.31 / $2.31 / $2.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $6.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $4.13 / $5.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.38 / $3.92 / $4.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.44 / $2.88 / $18.03
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $4.13 / $5.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.98 / $6.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.01 / $3.62 / $4.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.81 / $3.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.26 / $3.26 / $3.26