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Maryland 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
$18.20 / $33.88 / $41.69
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $54.95 / $77.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $54.95 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $26.92 / $37.15