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Idaho 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
$20.32 / $43.86 / $51.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $23.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.29 / $48.40 / $59.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.36 / $56.33 / $59.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.53 / $21.80 / $115.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.70 / $23.37 / $24.56