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Kentucky 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
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $36.31 / $42.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.89 / $29.51 / $31.62
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $51.29 / $66.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $53.70 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $34.67 / $245.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $22.39 / $30.90