go back

South Dakota rates for HCPCS V2715

Prism, Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.86 / $13.39 / $14.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.88 / $19.88 / $24.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.63 / $13.92 / $23.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.56 / $6.96 / $124.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.00 / $17.59 / $31.18
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.89 / $14.39 / $15.91
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.28 / $13.95 / $17.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.45 / $5.80 / $14.88
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.39 / $14.39 / $14.39