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South Dakota rates for HCPCS A6412

Eye patch, occlusive, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.50 / $0.50 / $0.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.17 / $4.17 / $5.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.23 / $0.39 / $0.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.20 / $10.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.48 / $0.54 / $0.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.13 / $0.20 / $0.39
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60