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Illinois rates for HCPCS V2104

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

Facilitymedian $39 · 10th–90th $39–$390%50%100%$39Professionalmedian $37 · 10th–90th $22–$520%20%10th90th$37$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $37.15 / $45.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $72.44 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $60.26
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $48.98 / $66.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $23.99 / $67.61