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South Dakota rates for HCPCS 92019

Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $87.10 / $125.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $162.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $100.00 / $141.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81