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

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

Rates data updated July 2026.

Facilitymedian $71 · 10th–90th $62$710%50%10th$71Professionalmedian $39 · 10th–90th $25$510%20%10th90th$39$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$39.81
Typical High
$51.29
CareSource
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
CareSource
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
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
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$28.84
Typical High
$37.15