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South Dakota rates for HCPCS V2201

Sphere Bifocal Plus Or Minus 4.12 To Plus Or Minus 7.00d Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.47 / $58.59 / $75.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.00 / $78.00 / $97.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.59 / $77.34 / $127.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.82 / $34.90 / $426.48
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.00 / $76.95 / $136.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.01 / $65.93 / $69.66
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.52 / $77.34 / $97.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.20 / $30.82 / $64.31
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.96 / $62.96 / $62.96