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Rhode Island 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
$18.20 / $33.11 / $40.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $32.36 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $22.39 / $34.67