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South Dakota rates for HCPCS V2502

Contact lens PMMA, bifocal, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.79 / $174.42 / $200.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.00 / $246.00 / $307.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.93 / $205.03 / $338.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.68 / $102.29 / $1,182.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.00 / $237.15 / $420.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.76 / $194.24 / $214.72
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.01 / $205.03 / $257.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.51 / $81.68 / $195.26
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.03 / $194.03 / $194.03