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South Dakota rates for HCPCS Q4041

Cast Supplies Long Leg Splint Adult (11 Years +) Plaster

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.93 / $15.93 / $15.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.93 / $15.93 / $17.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.00 / $37.00 / $46.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.88 / $28.88 / $36.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.20 / $28.85 / $46.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.94 / $19.89 / $197.89
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.40 / $28.47 / $35.95
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.85 / $27.86 / $52.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.83 / $24.98 / $33.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.28 / $19.89 / $20.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.48 / $22.48 / $22.48