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South Dakota rates for HCPCS V2205

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.77 / $61.84 / $77.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.50 / $85.50 / $106.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.77 / $79.70 / $131.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.76 / $35.01 / $444.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.00 / $77.19 / $136.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.22 / $67.94 / $69.89
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.48 / $79.70 / $100.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.41 / $31.76 / $66.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.15 / $63.15 / $63.15