go back

South Dakota rates for HCPCS V2305

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.61 / $78.28 / $96.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.27 / $108.38 / $135.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.63 / $98.95 / $163.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.43 / $46.62 / $529.40
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.80 / $104.00 / $182.23
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.19 / $84.35 / $93.07
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.54 / $98.95 / $124.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.50 / $39.43 / $82.28
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.11 / $84.11 / $84.11