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Pennsylvania rates for HCPCS V2101

Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.74 / $39.79 / $53.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.53 / $60.53 / $60.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.22 / $66.22 / $66.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.78 / $23.78 / $23.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.67 / $89.45 / $143.35
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.77 / $39.90 / $53.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $25.00 / $25.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.22 / $66.22 / $66.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.78 / $23.78 / $23.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.27 / $43.27 / $57.61
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.27 / $57.61 / $62.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.71 / $30.20 / $50.33