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Idaho 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
$16.86 / $41.69 / $44.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.59 / $19.59 / $19.59
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.24 / $42.64 / $51.06
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.07 / $48.51 / $52.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.19 / $79.14 / $99.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.82 / $19.38 / $20.36