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Ohio 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 / $50.70 / $62.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.60 / $31.46 / $86.43
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.59 / $79.91 / $99.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.25 / $86.57 / $159.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $31.15
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $31.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.58 / $32.38 / $42.27