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

Montana 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.

Facilitymedian $49 · 10th–90th $35$620%50%10th90th$49Professionalmedian $42 · 10th–90th $32$490%20%40%10th90th$42$10.0$20.0$50.0$100.0$200.0

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
$32.36
Median
$41.69
Typical High
$42.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$48.98
Typical High
$61.66
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$48.98
Typical High
$61.66
Providence
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$41.69
Typical High
$52.48
Providence
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$44.67
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$20.42
Typical High
$33.88