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Massachusetts rates for HCPCS V2104

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

Facilitymedian $47 · 10th–90th $39–$660%10%20%10th90th$47Professionalmedian $36 · 10th–90th $19–$460%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
$18.20 / $36.31 / $45.71
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $43.65 / $66.07
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $30.20 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $23.99
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $60.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $39.81 / $39.81
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $43.65 / $66.07
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $30.20 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $23.99 / $39.81