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

New Hampshire 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 $7 · 10th–90th $7$510%20%40%90th$7Professionalmedian $36 · 10th–90th $19$490%20%10th90th$36$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$28.84
Typical High
$41.69
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$23.99
Typical High
$39.81
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$7.08
Median
$7.08
Typical High
$51.29
Well Sense
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$37.15