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Minnesota rates for HCPCS V2104

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

Facilitymedian $46 · 10th–90th $36–$1410%20%10th90th$46Professionalmedian $40 · 10th–90th $25–$520%20%10th90th$40$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $48.98 / $48.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $48.98 / $48.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $158.49 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $60.26 / $70.79
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $147.91 / $302.00
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $60.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $42.66 / $48.98
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $44.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $22.39 / $72.44