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Hawaii 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.43 / $50.58 / $69.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.56 / $28.56 / $91.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.95 / $115.95 / $115.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.24 / $42.88 / $103.29
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.00 / $72.52 / $78.83