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South Dakota rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $479 · 10th–90th $398–$8320%20%40%10th90th$479Professionalmedian $389 · 10th–90th $195–$4790%10%20%10th90th$389$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $380.19 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $524.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $831.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $2,398.83
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $549.54 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $194.98 / $407.38
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54