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Michigan rates for HCPCS V2522

Contact Lens Hydrophillic Bifocal Per Lens (Special Coverage Instructions Apply. See Cim: 45-7 65-1)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.57 / $168.98 / $185.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.64 / $212.64 / $212.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.01 / $223.27 / $287.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.80 / $101.80 / $307.97
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.22 / $169.63 / $212.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.84 / $99.86 / $141.08