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South Dakota rates for HCPCS V2522

Contact lens, hydrophilic, bifocal, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.04 / $207.11 / $236.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.38 / $246.38 / $307.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.11 / $215.40 / $386.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.49 / $105.81 / $1,614.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.00 / $311.06 / $551.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.79 / $254.76 / $281.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.90 / $212.08 / $266.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.84 / $88.18 / $185.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.50 / $254.50 / $254.50