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South Dakota rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $1,122 · 10th–90th $955–$2,0420%20%40%10th90th$1,122Professionalmedian $1,122 · 10th–90th $955–$1,6220%20%10th90th$1,122$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,047.13 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,584.89 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $724.44 / $7,943.28
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,148.15 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $831.76 / $1,318.26
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $2,951.21