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Wisconsin rates for HCPCS V2204

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

Facilitymedian $66 · 10th–90th $55$2400%20%10th90th$66Professionalmedian $55 · 10th–90th $30$1000%10%20%10th90th$55$20.0$50.0$100.0$200.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $53.70 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $95.50 / $128.82
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $56.23 / $66.07
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $120.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $102.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $32.36 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $66.07 / $102.33
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $102.33 / $194.98
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $371.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $302.00 / $407.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $70.79 / $100.00