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Washington 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
$34.33 / $67.93 / $72.86
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.06 / $423.96 / $10,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.79 / $500.06 / $763.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.71 / $38.71 / $38.71
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.42 / $91.90 / $227.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.03 / $92.67 / $180.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $70.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.00 / $81.26 / $88.56
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.20 / $40.24 / $76.76