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Indiana 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
$39.10 / $42.75 / $48.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.72 / $24.72 / $37.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.60 / $74.88 / $80.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.60 / $63.36 / $72.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $59.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.37 / $26.56 / $36.10