go back

South Dakota rates for HCPCS Q0112

All potassium hydroxide (KOH) preparations

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.44 / $33.44 / $33.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.11 / $5.11 / $8.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.75 / $6.75 / $8.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.59 / $6.85 / $85.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $4.69 / $8.78
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.87 / $8.19 / $9.67
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $9.67 / $15.22
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.97 / $13.61 / $16.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $4.69 / $7.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.83 / $5.83 / $5.83