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Maine 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
$23.99 / $41.69 / $47.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $23.44 / $23.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $39.81 / $47.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $24.55 / $42.66