go back

South Dakota rates for HCPCS 65155

Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,548.13 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,148.15 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,290.87 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $1,288.25 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,288.25 / $7,244.36
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,445.44 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,548.82 / $2,454.71
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $2,187.76