go back

Wisconsin 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 $79 · 10th–90th $59–$2820%20%10th90th$79Professionalmedian $58 · 10th–90th $29–$1000%10%10th90th$58$10.0$20.0$50.0$100.0$200.0

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
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $52.48 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $114.82 / $154.88
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $66.07 / $79.43
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $69.18 / $123.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $38.02 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $123.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $109.65 / $177.83
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $338.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $354.81 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $70.79 / $100.00