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Utah rates for HCPCS V2501

Contact lens, PMMA, toric or prism ballast, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $99.01 / $126.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.33 / $71.33 / $71.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $60.00 / $161.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.04 / $74.14 / $111.67