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Washington, DC 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
$20.21 / $38.74 / $48.97
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.32 / $41.32 / $41.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $21.70 / $21.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.98 / $58.98 / $58.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.80 / $29.42 / $51.68