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Wisconsin rates for HCPCS V2305

Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.28 / $78.28 / $78.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.59 / $78.28 / $89.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.91 / $86.91 / $106.53
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.98 / $199.98 / $199.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.41 / $293.80 / $333.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.86 / $135.47 / $176.86
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.56 / $78.28 / $93.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.25 / $82.19 / $144.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.85 / $46.62 / $87.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.25 / $78.28 / $93.45
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.45 / $143.82 / $271.69
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.70 / $189.70 / $486.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.86 / $410.67 / $529.40
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.45 / $93.45 / $93.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.45 / $93.45 / $1,000,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.50 / $46.62 / $77.70