go back

South Dakota rates for HCPCS V2744

Tint Photochromatic Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.93 / $16.73 / $19.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.75 / $24.75 / $30.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.23 / $19.62 / $32.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $9.82 / $124.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $21.66 / $38.40
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.79 / $17.75 / $19.61
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.73 / $19.69 / $24.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.69 / $8.19 / $16.37
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.72 / $17.72 / $17.72