go back

Idaho 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
$26.80 / $58.14 / $66.04
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
$44.68 / $61.58 / $75.43
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.71 / $71.66 / $75.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.35 / $116.92 / $147.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.93 / $30.81 / $32.38