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Maine 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 / $39.93 / $56.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.69 / $163.69 / $163.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.50 / $86.53 / $86.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $31.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.75 / $56.75 / $56.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.35 / $39.93 / $56.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.19 / $34.72 / $79.84