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South Dakota rates for HCPCS A6258

Transparent film, sterile, more than 16 sq in but less than or equal to 48 sq in, each dressing

Facilitymedian $6 · 10th–90th $3–$90%20%10th90th$6Professionalmedian $4 · 10th–90th $3–$80%20%10th90th$4$2.0$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
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $7.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.91 / $8.91 / $11.22
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $8.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.07 / $6.46 / $8.32
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.40 / $2.51 / $30.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $6.61 / $6.61
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $5.50 / $10.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.75 / $6.03 / $7.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $3.02 / $6.76
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $5.37 / $5.37