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

Pennsylvania 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 $170 · 10th–90th $55$2190%50%10th90th$170Professionalmedian $34 · 10th–90th $17$480%20%10th90th$34$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$33.88
Typical High
$47.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$19.05
Typical High
$19.05
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$81.28
Typical High
$120.23
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$54.95
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$42.66
Typical High
$54.95
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$33.88
Typical High
$47.86
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$169.82
Typical High
$218.78
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$44.67
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$26.92
Typical High
$41.69