Bifocal eyeglass lens, high prescription power, per 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

Lens sphcy bifocal 4.25-7/2.

Payers reporting HCPCS V2208

Payer pricing summary

Low

$24

Average

$96

Median

$85

High

$255

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$79	$83	$17	21%	—	$22 – $244
2	Aetna fee schedule · outpatient · +12 other terms	321	$81	$97	$53	55%	—	$34 – $586
3	Humana fee schedule · outpatient · +9 other terms	316	$81	$122	$127	104%	—	$58 – $615
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$80	$101	$68	67%	—	$0 – $390
5	WellCare fee schedule · outpatient · +4 other terms	202	$81	$85	$17	20%	—	$71 – $177
6	Devoted fee schedule · outpatient · +2 other terms	164	$80	$80	$2	3%	—	$77 – $100
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$83	$82	$5	6%	—	$78 – $101
8	Molina fee schedule · outpatient · +5 other terms	109	$104	$110	$42	38%	—	$70 – $209
9	Cigna fee schedule · outpatient · +6 other terms	95	$81	$94	$31	33%	—	$73 – $227
10	Anthem fee schedule · outpatient · +6 other terms	74	$83	$87	$13	15%	—	$72 – $153
11	Kaiser fee schedule · outpatient · +4 other terms	61	$86	$128	$86	67%	—	$73 – $539
12	Superior Healthplan fee schedule · outpatient	40	$84	$84	$0	0%	—	$78 – $84
13	Clover fee schedule · outpatient · +2 other terms	37	$89	$85	$4	5%	—	$78 – $98
14	Ambetter facility · fee schedule · outpatient · +5 other terms	32	$133	$150	$31	21%	—	$76 – $194
15	Oscar fee schedule · outpatient · +3 other terms	32	$81	$92	$27	29%	—	$78 – $160
16	Optum fee schedule · outpatient · +3 other terms	26	$81	$94	$37	40%	—	$71 – $200
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$66	$60	91%	—	$20 – $196
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$88	$82	$10	12%	—	$61 – $89
19	Bcbs Tx fee schedule · outpatient	18	$78	$78	—	—	—	$78 – $78
20	Medicare fee schedule · outpatient · +1 other terms	18	$81	$81	$1	1%	—	$81 – $83
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$93	$92	$2	2%	—	$88 – $93
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$73	$85	$21	25%	—	$40 – $116
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$67	$67	$16	23%	—	$32 – $78
24	Wellmark fee schedule · both · +1 other terms	13	$68	$69	$6	9%	—	$68 – $105
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$60	$67	$8	12%	—	$60 – $76

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