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Hawaii 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
$43.71 / $58.14 / $75.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $94.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.63 / $119.63 / $119.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.35 / $46.77 / $106.59
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.20 / $74.83 / $81.34