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South Dakota rates for HCPCS A6242

Hydrogel dressing, wound cover, sterile, pad size 16 sq in or less, without adhesive border, each dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.39 / $5.39 / $5.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.39 / $5.39 / $5.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.50 / $12.50 / $15.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.75 / $9.75 / $12.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.93 / $9.23 / $11.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.38 / $6.75 / $42.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.27 / $9.65 / $12.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.74 / $9.31 / $14.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.07 / $9.30 / $11.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.81 / $5.40 / $7.04
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.61 / $7.61 / $7.61