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South Dakota rates for HCPCS B4087

Gastrostomy/Jejunostomy Tube Standard Any Material Any Type Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.18 / $33.18 / $33.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.18 / $33.18 / $40.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.38 / $36.74 / $45.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.08 / $57.59 / $110.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.51 / $35.27 / $61.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.15 / $45.47 / $52.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.24 / $52.89 / $85.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.52 / $34.84 / $41.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.51 / $17.27 / $61.72
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.34 / $41.34 / $41.34