go back

South Dakota rates for HCPCS V2631

Iris Supported Intraocular Lens (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.58 / $119.66 / $139.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.75 / $165.75 / $207.19
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.52 / $142.87 / $235.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.92 / $71.27 / $711.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.16 / $278.60 / $278.60
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $142.29 / $278.60
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.16 / $142.87 / $179.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.44 / $56.92 / $118.79
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.58 / $128.58 / $128.58