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Utah rates for HCPCS V2204

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

Professionalmedian $55 · 10th–90th $26$660%20%10th90th$55$20.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $54.95 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $63.10
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $69.18 / $77.62
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $69.18 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $32.36 / $48.98