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Utah 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
$19.17 / $39.43 / $64.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.56 / $28.56 / $28.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.44 / $52.89 / $58.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.24 / $29.69 / $49.48