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South Dakota rates for HCPCS A6404

Gauze, nonimpregnated, sterile, pad size more than 48 sq in, without adhesive border, each dressing

Facilitymedian $0 · 10th–90th $0–$10%10%10th90th$0Professionalmedian $1 · 10th–90th $0–$10%20%10th90th$1$0.2$0.5$1.0$2.0$5.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.50 / $0.50 / $0.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.76 / $0.76 / $0.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.25 / $0.39 / $0.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.18 / $0.22 / $5.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.48 / $0.54 / $0.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.71 / $0.71 / $0.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.13 / $0.22 / $0.42
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60