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South Dakota rates for HCPCS V2321

Lenticular Lens, Per Lens, Trifocal

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.21 / $118.24 / $137.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.56 / $163.50 / $204.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.24 / $141.16 / $232.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.24 / $70.42 / $851.58
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $155.28 / $275.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.33 / $127.18 / $140.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.75 / $141.16 / $177.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.14 / $56.24 / $117.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.04 / $127.04 / $127.04