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

Washington 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 $50 · 10th–90th $30$1100%10%20%10th90th$50Professionalmedian $33 · 10th–90th $17$560%10%10th90th$33$10.0$50.0$200.0$1.0K$5.0K

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
$16.98
Median
$33.11
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$50.12
Typical High
$117.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$48.98
Typical High
$89.13
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$50.12
Typical High
$51.29
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
United
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$20.42
Typical High
$38.90
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$54.95