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South Dakota rates for HCPCS 92136

Oph Bmtry Prtl Coher Intrfrmtry Io Lens Pwr Cal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.28 / $52.28 / $106.48
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.17 / $33.17 / $33.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.84 / $84.81 / $213.60
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.33 / $30.26 / $50.34
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$23.96 / $23.96 / $70.69
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$17.62 / $56.46 / $79.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.66 / $99.83 / $123.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.41 / $62.11 / $77.64
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.29 / $37.86 / $45.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.81 / $95.84 / $205.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.83 / $113.51 / $459.15
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.89 / $48.66 / $188.73
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$39.40 / $70.80 / $313.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.21 / $115.63 / $141.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.13 / $132.22 / $144.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.58 / $88.75 / $147.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$30.16 / $50.50 / $57.57
Sanford Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.08 / $33.64 / $96.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.68 / $81.18 / $181.44
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.71 / $39.42 / $63.44
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.64 / $39.40 / $118.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $102.20 / $106.30
Wellmark
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.80 / $64.50 / $67.09
Wellmark
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.00 / $37.70 / $39.20