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California rates for HCPCS V2109

Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens

Facilitymedian $68 · 10th–90th $40–$1410%20%10th90th$68Professionalmedian $52 · 10th–90th $24–$720%20%10th90th$52$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $52.48 / $66.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $58.88 / $81.28
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $186.21 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $33.11 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $91.20
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $575.44 / $575.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $61.66 / $79.43
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $72.44
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $29.51 / $70.79