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Montana rates for HCPCS V2304

Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25 to 4.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.93 / $68.63 / $75.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.71 / $38.71 / $38.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.29 / $63.37 / $88.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.71 / $72.86 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.36 / $40.24 / $57.72