go back

Single Vision Spherocylinder, Plano to +/-4.00d/0.12-2.00d

Hawaii rates for HCPCS V2103

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

Rates data updated July 2026.

Professionalmedian $30 · 10th–90th $17$430%20%10th90th$30$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$30.20
Typical High
$42.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$53.70
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$22.91
Typical High
$60.26