go back

Alabama rates for HCPCS V2104

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.00 / $37.61 / $40.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $21.70 / $21.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $18.80 / $27.13