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Illinois 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
$30.35 / $51.34 / $61.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.27 / $99.89 / $99.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $78.02
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.44 / $66.59 / $102.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.56 / $93.23 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.35 / $32.67 / $49.89