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

New Mexico 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 $43 · 10th–90th $28$590%10%20%10th90th$43Professionalmedian $38 · 10th–90th $20$460%20%10th90th$38$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$38.02
Typical High
$45.71
BCBS
Setting
Professional
Modifier
Global
Typical Low
$6.46
Median
$30.90
Typical High
$41.69
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Molina
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$60.26
Typical High
$95.50
Providence
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$42.66
Typical High
$58.88
Providence
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
United
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$22.39
Typical High
$33.88