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Utah rates for HCPCS V2115

Lenticular (Myodisc), Per Lens, Sngle Vision

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.60 / $59.16 / $92.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.61 / $42.61 / $42.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $60.00 / $94.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $44.29 / $66.73