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Indiana rates for HCPCS V2104

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

Facilitymedian $19 · 10th–90th $19–$590%50%90th$19Professionalmedian $36 · 10th–90th $20–$420%20%10th90th$36$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
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $36.31 / $41.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $22.39 / $37.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $20.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $34.67