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Montana rates for HCPCS V2113

Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $64.57 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $74.13 / $93.33
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $74.13 / $93.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $77.62 / $81.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $37.15 / $53.70