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South Carolina 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
$28.84 / $53.70 / $61.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $69.18 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $57.54 / $72.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $31.62 / $40.74