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Pennsylvania 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
$31.80 / $64.89 / $81.26
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.81 / $92.81 / $92.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.17 / $108.17 / $108.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.14 / $36.14 / $36.14
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.69 / $132.56 / $212.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.26 / $65.81 / $81.26
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $25.00 / $25.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.17 / $108.17 / $108.17
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.14 / $36.14 / $36.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.36 / $66.36 / $88.33
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.36 / $88.33 / $93.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.56 / $46.30 / $77.17