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West Virginia 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
$49.42 / $55.36 / $75.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.58 / $103.84 / $116.82
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.78 / $95.18 / $200.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.58 / $83.58 / $83.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.15 / $31.15 / $31.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.38 / $43.17 / $138.44