go back

Pennsylvania rates for HCPCS V2104

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

Facilitymedian $60 · 10th–90th $60–$810%50%90th$60Professionalmedian $37 · 10th–90th $20–$510%20%10th90th$37$1.0$5.0$20.0$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $37.15 / $51.29
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.12
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.39
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $134.90
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $46.77 / $60.26
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $44.67 / $44.67
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.12
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $36.31 / $51.29
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $25.12
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $42.66 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $29.51 / $45.71