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North Dakota 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
Professional
Modifier
Low / Median / High Price
$40.93 / $48.24 / $48.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.75 / $67.42 / $84.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.93 / $40.93 / $57.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.61 / $23.53 / $315.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.23 / $19.61 / $39.22