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Montana rates for HCPCS V2203

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 0.12 to 2.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.13 / $61.90 / $150.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.80 / $29.80 / $29.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.38 / $47.11 / $65.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.80 / $65.72 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.99 / $30.97 / $44.43