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

Washington 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 $85 · 10th–90th $58$2040%10%20%10th90th$85Professionalmedian $68 · 10th–90th $33$1050%10%20%10th90th$68$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$67.61
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$213.80
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$89.13
Typical High
$177.83
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$87.10
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$39.81
Typical High
$77.62
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$107.15