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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

Professionalmedian $52 · 10th–90th $24–$650%10%20%10th90th$52$10.0$20.0$50.0$100.0

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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $43.65 / $58.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $58.88 / $67.61
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $29.51 / $44.67