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Alaska rates for HCPCS V2103

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 0.12 to 2.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $36.31 / $46.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $44.67 / $44.67
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $46.77 / $52.48
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $43.65 / $52.48
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $79.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $22.91 / $91.20