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Pennsylvania rates for HCPCS V2201

Sphere Bifocal Plus Or Minus 4.12 To Plus Or Minus 7.00d Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.27 / $53.83 / $76.26
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.09 / $87.09 / $87.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.14 / $87.14 / $87.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.19 / $32.19 / $32.19
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.74 / $120.30 / $192.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.84 / $54.02 / $76.26
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $35.00 / $40.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.14 / $87.14 / $87.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.19 / $32.19 / $32.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.27 / $62.27 / $82.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.27 / $82.89 / $84.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.46 / $43.45 / $72.42