go back

Nebraska rates for HCPCS V2115

Lenticular (Myodisc), Per Lens, Sngle Vision

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.83 / $71.83 / $71.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.83 / $74.37 / $92.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.61 / $123.00 / $153.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.83 / $103.36 / $161.29
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.79 / $44.29 / $69.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.42 / $97.66 / $173.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.67 / $88.42 / $201.19
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $25.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.53 / $44.29 / $48.02