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Maryland 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
$88.08 / $168.83 / $225.10
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.08 / $180.08 / $180.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.60 / $104.60 / $104.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.50 / $264.77 / $385.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.72 / $128.25 / $173.88