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Missouri 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
$25.17 / $36.02 / $43.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.79 / $26.12 / $41.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.19 / $21.70 / $21.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.27 / $43.80 / $85.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.66 / $22.55 / $68.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.66 / $21.85 / $33.97