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Michigan 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 / $53.63 / $56.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.59 / $66.59 / $66.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.26 / $69.92 / $89.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $96.56
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.15 / $53.84 / $62.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.26 / $13.87 / $18.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.35 / $31.28 / $44.51