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Utah 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
$30.90 / $67.61 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $36.31 / $36.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $56.23 / $69.18
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $75.86 / $81.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $37.15 / $56.23