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New Hampshire 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
$15.85 / $32.36 / $40.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $35.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $20.42 / $35.48
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $28.84