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South Dakota rates for HCPCS V2107

Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, 0.12 to 2.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.02 / $47.58 / $54.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.50 / $66.00 / $82.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.02 / $56.03 / $92.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.32 / $25.91 / $332.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.13 / $58.00 / $101.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.80 / $47.76 / $51.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.74 / $56.03 / $70.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.29 / $22.32 / $55.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.75 / $46.75 / $46.75