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South Dakota rates for HCPCS Q4130

Strattice Tm Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.66 / $5.66 / $5.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.66 / $5.66 / $25.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.57 / $42.25 / $85.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.27 / $37.27 / $37.27