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Bifocal Lens, Sphere +/-4.12-7.00d

Massachusetts rates for HCPCS V2201

Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens

Rates data updated July 2026.

How much does Bifocal Lens, Sphere +/-4.12-7.00d cost?

$53.70

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $69.18 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$38.02 to $61.66
FacilityA hospital or hospital-owned outpatient department$69.18$60.26 to $72.44

How much rates vary

Facilitymedian $69 · 10th to 90th $60 to $105Professionalmedian $54 · 10th to 90th $28 to $68
$20.0$50.0$100.0$200.0$500.0facility $69professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$53.70
Typical High
$66.07
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$69.18
Typical High
$104.71
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$60.26
Typical High
$60.26
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$61.66
Typical High
$61.66
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$69.18
Typical High
$104.71
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$43.65
Typical High
$61.66

Where Massachusetts sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Massachusetts $53.70 · 31st of 51
WY $66.07RI $44.67

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.