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Utah 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
$15.85 / $33.75 / $48.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $23.63 / $23.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.94 / $43.78 / $48.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.23 / $24.56 / $36.99