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

South Dakota 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 $89 · 10th–90th $68$1510%20%10th90th$89Professionalmedian $68 · 10th–90th $51$890%20%40%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
$51.29
Median
$67.61
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$120.23
Medica
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$89.13
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$40.74
Typical High
$501.19
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$100.00
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$35.48
Typical High
$85.11
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07