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Single Vision Spherocylinder, Plano to +/-4.00d/0.12-2.00d

South Dakota rates for HCPCS V2103

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 0.12 to 2.00d cylinder, per lens

Rates data updated July 2026.

Facilitymedian $50 · 10th–90th $28$870%20%10th90th$50Professionalmedian $38 · 10th–90th $24$500%20%10th90th$38$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$35.48
Typical High
$48.98
Avera
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$53.70
Typical High
$54.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$67.61
Medica
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$50.12
Typical High
$87.10
Medica
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$20.42
Typical High
$263.03
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$56.23
Typical High
$67.61
United
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$19.95
Typical High
$47.86
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11