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South Dakota rates for HCPCS V2204

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

Facilitymedian $69 · 10th–90th $52–$1170%20%40%10th90th$69Professionalmedian $55 · 10th–90th $41–$660%20%40%10th90th$55$20.0$50.0$100.0$200.0

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
$50.12 / $53.70 / $61.66
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $95.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $69.18 / $117.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $32.36 / $407.38
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $77.62 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $27.54 / $67.61
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88