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

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

Rates data updated July 2026.

Professionalmedian $29 · 10th–90th $19$360%20%10th90th$29$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$18.62
Median
$28.84
Typical High
$36.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$32.36
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
United
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$23.99
Typical High
$34.67