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Minnesota 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
Facility
Modifier
Low / Median / High Price
$243.38 / $243.38 / $243.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.21 / $201.54 / $243.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.57 / $112.57 / $112.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.57 / $290.57 / $290.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$663.52 / $830.22 / $1,043.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.12 / $370.43 / $427.67
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$663.52 / $822.00 / $1,724.55
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.75 / $336.75 / $336.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.70 / $242.38 / $290.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $110.02 / $218.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $108.72 / $203.11