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New Hampshire 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
$19.57 / $22.45 / $43.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.09 / $65.64 / $65.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $23.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.15 / $40.15 / $40.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.19 / $24.56 / $39.22
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.33 / $36.65 / $46.66