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South Dakota rates for HCPCS V2503

Contact Lens, Pmma,Color Vision Deficiency,Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.40 / $143.31 / $171.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.75 / $237.75 / $297.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.65 / $168.60 / $278.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.17 / $84.11 / $1,079.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.00 / $185.46 / $328.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.71 / $151.90 / $167.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.63 / $168.60 / $212.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.86 / $70.09 / $205.09
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.74 / $151.74 / $151.74