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South Dakota rates for HCPCS Q4021

Cast Supplies Short Arm Splint Adult (11 Years +) Plaster

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.37 / $5.37 / $5.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.37 / $6.58 / $7.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.50 / $12.50 / $15.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.75 / $9.75 / $12.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.42 / $9.96 / $15.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.36 / $6.71 / $137.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.23 / $9.60 / $12.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.70 / $9.39 / $22.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $8.42 / $11.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.98 / $7.00 / $9.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.58 / $7.58 / $7.58