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South Dakota rates for HCPCS E0443

Portable oxygen contents, gaseous, 1 month's supply = 1 unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.78 / $39.78 / $39.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.89 / $49.40 / $61.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.86 / $49.86 / $78.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.63 / $72.34 / $89.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.38 / $73.95 / $283.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.31 / $43.68 / $97.80
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.65 / $78.68 / $101.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.65 / $85.19 / $162.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.13 / $69.68 / $81.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.39 / $32.76 / $55.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.89 / $76.89 / $76.89