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Arizona 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
$19.05 / $36.31 / $44.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $39.81 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $38.90 / $61.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $22.39 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $22.39 / $33.88