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New Hampshire 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
$26.80 / $31.73 / $56.83
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.32 / $34.72 / $41.84
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.10 / $56.52 / $89.21