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Minnesota 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
$55.77 / $55.77 / $55.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.73 / $55.77 / $58.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.59 / $66.59 / $66.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.90 / $66.59 / $66.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.29 / $190.56 / $239.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.02 / $84.98 / $98.11
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.29 / $188.67 / $395.83
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.75 / $77.25 / $77.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.62 / $60.01 / $69.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.58 / $26.98 / $61.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.58 / $26.98 / $65.78