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Hawaii 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
$28.00 / $42.94 / $85.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.59 / $19.59 / $53.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.50 / $68.50 / $68.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.94 / $29.42 / $61.02
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.76 / $42.84 / $46.57