go back

South Dakota rates for HCPCS A6453

Self-adherent bandage, elastic, nonknitted/nonwoven, width less than 3 in, per yd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.56 / $0.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.25 / $0.27 / $0.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.50 / $1.50 / $1.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.81 / $0.93 / $1.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.35 / $0.69 / $4.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.96 / $1.01 / $1.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $0.97 / $1.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.72 / $0.88 / $1.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.73 / $1.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.79 / $0.79 / $0.79