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Single Vision Spherocylinder, Plano to +/-4.00d/2.12-4.00d

Nebraska rates for HCPCS V2104

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

Rates data updated July 2026.

Facilitymedian $46 · 10th–90th $36$790%20%10th90th$46Professionalmedian $36 · 10th–90th $22$440%20%40%10th90th$36$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
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$36.31
Typical High
$36.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$36.31
Typical High
$43.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$70.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$54.95
Typical High
$81.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$22.39
Typical High
$35.48
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$25.12
United
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$22.39
Typical High
$70.79