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Minnesota rates for HCPCS V2104

Spherocylinder Single Vision Plano To Plus Or Minus 4.00d Sphere 2.12 To 4.00d Cylinder Per Lens

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.56 / $40.56 / $40.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.38 / $38.74 / $48.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.42 / $48.42 / $48.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.92 / $48.42 / $48.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.20 / $137.88 / $173.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.81 / $61.88 / $71.44
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.20 / $136.53 / $286.43
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.06 / $56.25 / $56.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.56 / $42.98 / $50.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $19.29 / $42.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $19.29 / $47.89