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South Dakota rates for HCPCS V2115

Lenticular (myodisc), per lens, single vision

Facilitymedian $105 · 10th–90th $72–$1820%20%40%10th90th$105Professionalmedian $85 · 10th–90th $55–$1020%20%10th90th$85$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $154.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $104.71 / $181.97
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $44.67 / $588.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $42.66 / $107.15
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43