go back

Nebraska 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
Facility
Modifier
Low / Median / High Price
$36.58 / $36.58 / $36.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.29 / $37.86 / $47.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $56.25 / $70.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.58 / $56.26 / $82.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $22.55 / $35.38
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.03 / $49.73 / $88.16
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.06 / $45.03 / $102.47
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $25.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $22.55 / $27.50