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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
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $52.48 / $63.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $100.00 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $81.28
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $66.07 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $32.36 / $46.77