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Pennsylvania rates for HCPCS V2204

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

Facilitymedian $89 · 10th–90th $89–$1170%50%90th$89Professionalmedian $54 · 10th–90th $28–$760%20%10th90th$54$1.0$5.0$20.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $53.70 / $75.86
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $186.21
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $67.61 / $89.13
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $53.70 / $75.86
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $34.67 / $39.81
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $61.66 / $83.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $43.65 / $60.26