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Hawaii rates for HCPCS V2105

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.75 / $41.85 / $57.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $62.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.55 / $79.55 / $79.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.23 / $35.08 / $70.88
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.34 / $49.75 / $54.08