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Michigan 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
$22.45 / $44.10 / $46.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.60 / $57.60 / $57.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.72 / $60.48 / $77.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $83.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.58 / $44.10 / $51.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.67 / $12.27 / $19.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.23 / $26.56 / $34.61