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Minnesota rates for HCPCS V2105

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.24 / $48.24 / $48.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.95 / $41.85 / $48.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.60 / $57.60 / $57.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.49 / $57.60 / $57.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.63 / $164.70 / $207.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.42 / $73.43 / $84.77
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.63 / $163.07 / $342.13
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.41 / $66.75 / $66.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.15 / $48.47 / $57.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.37 / $22.94 / $45.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.37 / $22.94 / $49.89