Bifocal lens with high power correction, 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/ov

Payers reporting HCPCS V2210

Payer pricing summary

Low

$24

Average

$115

Median

$104

High

$277

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$98	$102	$22	22%	—	$43 – $319
2	Aetna fee schedule · outpatient · +12 other terms	321	$99	$118	$62	53%	—	$48 – $643
3	Humana fee schedule · outpatient · +9 other terms	316	$109	$146	$141	97%	—	$69 – $695
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$110	$125	$86	69%	—	$0 – $493
5	WellCare fee schedule · outpatient · +4 other terms	202	$95	$101	$19	19%	—	$86 – $192
6	Devoted fee schedule · outpatient · +2 other terms	164	$91	$95	$9	9%	—	$87 – $119
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$113	$99	$12	12%	—	$90 – $121
8	Molina fee schedule · outpatient · +5 other terms	109	$129	$127	$47	37%	—	$76 – $237
9	Cigna fee schedule · outpatient · +6 other terms	95	$113	$118	$37	32%	—	$87 – $273
10	Anthem fee schedule · outpatient · +6 other terms	74	$91	$101	$17	17%	—	$86 – $186
11	Kaiser fee schedule · outpatient · +4 other terms	61	$93	$151	$114	76%	—	$87 – $705
12	Superior Healthplan fee schedule · outpatient	40	$95	$95	$0	0%	—	$89 – $95
13	Clover fee schedule · outpatient · +2 other terms	37	$97	$102	$9	8%	—	$95 – $116
14	Ambetter facility · fee schedule · outpatient · +5 other terms	32	$167	$195	$59	30%	—	$86 – $274
15	Oscar fee schedule · outpatient · +3 other terms	32	$115	$109	$23	21%	—	$89 – $160
16	Optum fee schedule · outpatient · +3 other terms	26	$101	$112	$41	37%	—	$85 – $226
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$75	$74	99%	—	$20 – $233
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$95	$93	$4	5%	—	$80 – $97
19	Bcbs Tx fee schedule · outpatient	18	$89	$89	—	—	—	$89 – $89
20	Medicare fee schedule · outpatient · +1 other terms	18	$87	$88	$1	1%	—	$87 – $89
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$132	$130	$3	2%	—	$125 – $132
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$93	$107	$27	25%	—	$51 – $147
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$84	$84	$20	23%	—	$41 – $99
24	Wellmark fee schedule · both · +1 other terms	13	$77	$78	$9	12%	—	$77 – $133
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$76	$89	$16	18%	—	$76 – $108

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