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Alaska rates for HCPCS V2204

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.14 / $61.58 / $76.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $31.15
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.22 / $76.06 / $91.27
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.66 / $75.91 / $79.91
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.75 / $76.06 / $91.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $88.39 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.24 / $39.86 / $156.61