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West Virginia 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
$35.94 / $40.26 / $51.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.68 / $70.78 / $79.62
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.25 / $64.88 / $136.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.59 / $58.59 / $58.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $21.70 / $21.70
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.47 / $37.47 / $37.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.55 / $29.42 / $94.37