Lenticular lens, single lens

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Lenticular lens, single

Payers reporting HCPCS V2121

Payer pricing summary

Low

$32

Average

$126

Median

$115

High

$290

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +10 other terms	336	$98	$103	$27	26%	—	$42 – $377
2	Aetna fee schedule · outpatient · +10 other terms	320	$102	$126	$80	63%	—	$41 – $988
3	Humana fee schedule · outpatient · +9 other terms	316	$96	$170	$200	118%	—	$73 – $951
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	210	$121	$135	$96	71%	—	$0 – $563
5	WellCare fee schedule · outpatient · +4 other terms	202	$107	$120	$21	17%	—	$91 – $201
6	Devoted fee schedule · outpatient · +2 other terms	163	$96	$113	$15	13%	—	$92 – $131
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$99	$115	$12	11%	—	$93 – $127
8	Molina fee schedule · outpatient · +5 other terms	109	$136	$163	$66	41%	—	$80 – $324
9	Cigna fee schedule · outpatient · +6 other terms	94	$97	$115	$36	32%	—	$91 – $311
10	Anthem fee schedule · outpatient · +6 other terms	74	$96	$102	$20	19%	—	$91 – $212
11	Kaiser fee schedule · outpatient · +4 other terms	61	$98	$175	$139	79%	—	$92 – $833
12	Superior Healthplan fee schedule · outpatient	40	$130	$130	$1	0%	—	$121 – $130
13	Clover fee schedule · outpatient · +2 other terms	37	$101	$106	$13	12%	—	$93 – $130
14	Oscar fee schedule · outpatient · +3 other terms	32	$121	$128	$36	28%	—	$97 – $210
15	Ambetter facility · fee schedule · outpatient · +5 other terms	29	$191	$193	$33	17%	—	$91 – $232
16	Optum fee schedule · outpatient · +3 other terms	26	$93	$118	$66	56%	—	$91 – $309
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$77	$78	102%	—	$20 – $247
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$100	$101	$4	4%	—	$95 – $109
19	Bcbs Tx fee schedule · outpatient	18	$121	$121	—	—	—	$121 – $121
20	Medicare fee schedule · outpatient · +1 other terms	18	$92	$92	$1	1%	—	$92 – $94
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$111	$110	$2	2%	—	$106 – $111
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$106	$122	$30	25%	—	$58 – $168
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$96	$96	$23	23%	—	$47 – $113
24	Wellmark fee schedule · both · +1 other terms	13	$82	$84	$11	13%	—	$82 – $152
25	Aetna Better Health fee schedule · outpatient · +4 other terms	12	$87	$88	$2	2%	—	$87 – $91

Page 1 of 3 · 52 payers