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Oklahoma 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
$115.50 / $174.51 / $180.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.92 / $202.92 / $202.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.60 / $104.60 / $104.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.22 / $174.51 / $266.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $110.46 / $234.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.48 / $104.48 / $155.97