go back

South Dakota rates for HCPCS A6455

Self-Adherent Bandage Elastic Non-Knitted/Non-Woven Width Greater Than Or Equal To Five Inches Per Yard

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.24 / $1.24 / $1.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.24 / $1.24 / $1.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $2.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.83 / $2.11 / $2.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.78 / $1.55 / $9.71
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.13 / $2.21 / $2.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.78 / $2.15 / $3.29
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.63 / $1.95 / $2.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.69 / $1.62 / $2.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $1.76 / $1.76