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New Hampshire rates for HCPCS V2115

Lenticular (myodisc), per lens, single vision

Facilitymedian $11 · 10th–90th $11–$1000%20%40%90th$11Professionalmedian $68 · 10th–90th $36–$850%20%10th90th$68$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $60.26 / $85.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $44.67 / $77.62
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $10.72 / $100.00
Well Sense
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $72.44