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South Dakota rates for HCPCS 92081

Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, Autoplot, arc perimeter, or single stimulus level automated test, such as Octopus 3 or 7 equivalent)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.98 / $36.88 / $48.83
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$15.21 / $16.85 / $35.83
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$12.96 / $17.96 / $23.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.17 / $63.34 / $85.93
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.55 / $29.53 / $39.93
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.62 / $33.42 / $46.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.78 / $48.64 / $74.45
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.15 / $42.29 / $354.38
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.11 / $20.46 / $98.32
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.07 / $21.83 / $180.44
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.92 / $76.53 / $90.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.86 / $69.88 / $89.26
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.25 / $51.48 / $65.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.62 / $22.67 / $30.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.62 / $28.70 / $38.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.92 / $40.82 / $50.70
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.62 / $18.78 / $25.36
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.04 / $21.83 / $26.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.10 / $61.60 / $64.09
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.20 / $29.00 / $30.10
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.90 / $32.70 / $34.00