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Indiana rates for HCPCS V2755

U-V Lens Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.97 / $15.31 / $19.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.64 / $8.64 / $14.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.11 / $26.14 / $28.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.11 / $22.12 / $25.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.57 / $9.57 / $20.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.63 / $9.44 / $12.85