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North Dakota 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
$201.54 / $243.38 / $243.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.75 / $340.12 / $427.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.54 / $201.54 / $290.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.60 / $115.76 / $1,394.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.13 / $96.57 / $383.55