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South Dakota rates for HCPCS V2511

Contact lens, gas permeable, toric, prism ballast, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.63 / $186.86 / $196.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.13 / $253.13 / $316.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.86 / $191.34 / $327.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.23 / $95.46 / $1,224.61
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.00 / $258.35 / $457.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.11 / $211.61 / $233.92
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.13 / $191.34 / $240.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.73 / $79.55 / $159.10
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.37 / $211.37 / $211.37