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Montana rates for HCPCS V2205

Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.72 / $64.37 / $64.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.68 / $33.68 / $33.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.26 / $57.04 / $79.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.68 / $68.34 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.64 / $35.01 / $58.35