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Arkansas rates for HCPCS V2521

Contact Lens Hydrophilic Toric Or Prism Ballast Per Lens (Special Coverage Instructions Apply. See Cim: 45-7 65-1)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.51 / $181.57 / $235.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179,999.82 / $179,999.82 / $539,999.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.05 / $264.77 / $294.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.14 / $174.14 / $174.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.08 / $104.60 / $107.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $107.75 / $139.04