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Oregon rates for HCPCS V2104

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

Facilitymedian $51 · 10th–90th $40–$560%50%10th90th$51Professionalmedian $39 · 10th–90th $18–$510%20%10th90th$39$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $38.90 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $97.72 / $120.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $43.65 / $53.70
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $42.66 / $56.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $56.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $45.71 / $53.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $50.12 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $22.39 / $35.48