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Maine rates for HCPCS V2104

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

Facilitymedian $110 · 10th–90th $110–$1100%50%100%$110Professionalmedian $39 · 10th–90th $20–$420%20%10th90th$39$10.0$20.0$50.0$100.0

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
$19.95 / $36.31 / $41.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $22.39 / $22.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $36.31 / $41.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $38.02 / $39.81