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South Dakota rates for HCPCS V2301

Sphere Trifocal Plus Or Minus 4.12 To Plus Or Minus 7.00d Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.70 / $78.48 / $90.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.13 / $122.25 / $152.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.17 / $92.34 / $152.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $46.07 / $601.62
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.57 / $103.00 / $180.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.70 / $83.18 / $91.96
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.02 / $92.34 / $116.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.07 / $36.79 / $76.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.11 / $83.11 / $83.11