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Indiana 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
$27.20 / $34.86 / $39.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.17 / $20.17 / $28.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.97 / $61.06 / $65.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.97 / $51.67 / $58.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.59 / $19.59 / $48.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $21.67 / $29.44