go back

Montana rates for HCPCS V2110

Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.95 / $48.44 / $51.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.19 / $28.19 / $28.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.35 / $42.03 / $58.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.19 / $51.42 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.48 / $29.30 / $29.30