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Michigan rates for HCPCS V2104

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

Facilitymedian $49 · 10th–90th $49–$490%50%100%$49Professionalmedian $37 · 10th–90th $20–$460%20%10th90th$37$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 / $37.15 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $48.98 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $70.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $38.90 / $45.71
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $39.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $22.91 / $34.67