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Trifocal Lens, Sphere Plano to +/-4.00d, Cylinder 2.25-4.00d

Pennsylvania rates for HCPCS V2304

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

Rates data updated July 2026.

Facilitymedian $302 · 10th–90th $105$4070%10%20%10th90th$302Professionalmedian $68 · 10th–90th $35$890%20%10th90th$68$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$70.79
Typical High
$89.13
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$229.09
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$104.71
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$70.79
Typical High
$89.13
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$316.23
Typical High
$407.38
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$97.72
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$51.29
Typical High
$79.43