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Maryland 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 / $37.15 / $44.67
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $60.26 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $29.51 / $39.81