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North Dakota 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
Professional
Modifier
Low / Median / High Price
$40.56 / $40.56 / $47.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.25 / $56.81 / $71.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.56 / $47.89 / $57.61
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.80 / $22.95 / $289.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.66 / $18.80 / $45.89