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Louisiana 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
$19.95 / $39.81 / $44.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $22.91 / $28.84