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

Virginia 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 $46 · 10th–90th $34$600%10%20%10th90th$46Professionalmedian $36 · 10th–90th $20$490%20%10th90th$36$10.0$20.0$50.0$100.0$200.0

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
$18.62
Median
$36.31
Typical High
$43.65
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$58.88
Typical High
$104.71
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$41.69
Typical High
$41.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Cigna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$57.54
Typical High
$70.79
Medcost
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$54.95
Medcost
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$38.90
Typical High
$60.26
Medcost
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$36.31
Sentara
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$46.77
Typical High
$60.26
Sentara
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$46.77
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$29.51
Typical High
$37.15