go back

South Dakota rates for HCPCS V2114

Spherocylinder Single Vision Sphere Over Plus Or Minus 12.00d Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $85.14 / $97.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.75 / $121.88 / $152.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.17 / $165.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.90 / $40.70 / $538.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $89.74 / $159.08
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.48 / $81.25 / $85.37
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.55 / $100.17 / $125.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.87 / $39.90 / $83.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.42 / $73.42 / $73.42