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Utah rates for HCPCS V2511

Contact lens, gas permeable, toric, prism ballast, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $162.18 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $60.26 / $169.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $190.55 / $229.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $194.98 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $95.50 / $144.54