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South Dakota rates for HCPCS E0442

Stationary oxygen contents, liquid, 1 month's supply = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $37.15 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $79.43 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $74.13 / $177.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $46.77 / $630.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $97.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $83.18 / $83.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $85.11
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $75.86 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $34.67 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28