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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
$28.18 / $39.81 / $51.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $53.70 / $53.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $245.47
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $37.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $29.51 / $37.15