go back

Wisconsin 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
Facility
Modifier
Low / Median / High Price
$74.31 / $74.31 / $74.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.10 / $71.77 / $76.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.51 / $82.51 / $101.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.86 / $189.86 / $189.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.80 / $279.05 / $317.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.14 / $128.44 / $167.91
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.78 / $74.31 / $88.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.08 / $78.03 / $137.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.31 / $44.26 / $82.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.08 / $74.31 / $88.72
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.25 / $133.08 / $219.11
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.10 / $180.10 / $397.43
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.14 / $389.88 / $474.71
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.72 / $88.72 / $88.72
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.72 / $88.72 / $1,000,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.42 / $42.41 / $70.66