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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
$45.71 / $56.23 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $77.62 / $131.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $34.67 / $426.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $87.10 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $30.90 / $64.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $63.10