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Washington rates for HCPCS V2115

Lenticular (myodisc), per lens, single vision

Facilitymedian $105 · 10th–90th $63–$2340%10%20%10th90th$105Professionalmedian $71 · 10th–90th $36–$1170%10%10th90th$71$10.0$50.0$200.0$1.0K$5.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $70.79 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $251.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $199.53
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $104.71
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $85.11
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $117.49