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North Dakota rates for HCPCS V2204

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.77 / $55.77 / $56.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.25 / $78.02 / $98.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.77 / $56.88 / $68.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.54 / $27.69 / $407.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.35 / $26.98 / $34.13