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South Dakota rates for HCPCS V2209

Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $67.61 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $123.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $83.18 / $144.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $43.65 / $436.52
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $93.33 / $109.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $33.11 / $69.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62