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North Carolina rates for HCPCS V2104

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

Facilitymedian $40 · 10th–90th $32–$560%20%40%10th90th$40Professionalmedian $39 · 10th–90th $20–$460%20%10th90th$39$10.0$20.0$50.0$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $38.02 / $42.66
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $45.71 / $45.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $33.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $39.81 / $53.70
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $25.12 / $34.67
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $21.38 / $28.18
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $457.09