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Montana rates for HCPCS V2114

Spherocylinder Single Vision Sphere Over Plus Or Minus 12.00d Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.26 / $71.98 / $95.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $39.15 / $39.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.06 / $71.69 / $100.17
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $76.42 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $40.70 / $58.39