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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
$32.36 / $70.79 / $81.28
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $144.54 / $218.78
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $72.44 / $95.50
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $67.61 / $81.28
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $25.12
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $66.07 / $93.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $46.77 / $67.61