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Single Vision Spherocylinder, Plano to +/-4.00d/2.12-4.00d

Maryland rates for HCPCS V2104

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

Rates data updated July 2026.

Facilitymedian $60 · 10th–90th $60$600%50%100%$60Professionalmedian $36 · 10th–90th $20$490%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
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$36.31
Typical High
$48.98
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$60.26
Typical High
$77.62
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$29.51
Typical High
$44.67