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Indiana 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
$173.13 / $215.66 / $235.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.78 / $124.78 / $177.18
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.57 / $377.74 / $406.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.57 / $319.63 / $363.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.60 / $104.60 / $298.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $134.03 / $194.15