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New Jersey 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
$19.05 / $37.15 / $44.67
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.95 / $19.95 / $25.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $67.61 / $83.18
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $30.20 / $37.15