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Washington 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 $66 · 10th–90th $43–$1580%10%20%10th90th$66Professionalmedian $52 · 10th–90th $24–$760%20%10th90th$52$10.0$50.0$200.0$1.0K$5.0K

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 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $67.61 / $162.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $67.61 / $131.83
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $64.57 / $66.07
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $29.51 / $56.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $79.43