Bifocal eyeglass lens, high prescription, 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 sphcyl bifo 7.25-12/4.2

Payers reporting HCPCS V2213

Payer pricing summary

Low

$26

Average

$124

Median

$110

High

$304

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$105	$105	$23	22%	—	$27 – $338
2	Aetna fee schedule · outpatient · +12 other terms	321	$106	$125	$63	51%	—	$46 – $681
3	Humana fee schedule · outpatient · +9 other terms	316	$108	$156	$157	101%	—	$75 – $767
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$106	$130	$91	70%	—	$0 – $528
5	WellCare fee schedule · outpatient · +4 other terms	202	$105	$109	$20	18%	—	$96 – $210
6	Devoted fee schedule · outpatient · +2 other terms	164	$104	$104	$8	8%	—	$94 – $128
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$110	$105	$8	8%	—	$100 – $129
8	Molina fee schedule · outpatient · +5 other terms	109	$129	$139	$53	38%	—	$98 – $261
9	Cigna fee schedule · outpatient · +6 other terms	95	$121	$123	$33	27%	—	$96 – $292
10	Anthem fee schedule · outpatient · +6 other terms	74	$121	$117	$15	13%	—	$98 – $199
11	Kaiser fee schedule · outpatient · +4 other terms	61	$127	$174	$114	66%	—	$102 – $747
12	Superior Healthplan fee schedule · outpatient	40	$105	$105	$1	0%	—	$98 – $105
13	Clover fee schedule · outpatient · +2 other terms	37	$106	$107	$3	3%	—	$104 – $126
14	Oscar fee schedule · outpatient · +3 other terms	32	$110	$114	$23	20%	—	$98 – $170
15	Ambetter facility · fee schedule · outpatient · +5 other terms	30	$179	$197	$49	25%	—	$102 – $261
16	Optum fee schedule · outpatient · +3 other terms	26	$113	$125	$44	35%	—	$92 – $249
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$78	$80	103%	—	$20 – $252
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$131	$120	$18	15%	—	$85 – $133
19	Bcbs Tx fee schedule · outpatient	18	$98	$98	—	—	—	$98 – $98
20	Medicare fee schedule · outpatient · +1 other terms	18	$121	$121	$1	1%	—	$121 – $123
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$125	$124	$2	2%	—	$119 – $125
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$100	$115	$28	25%	—	$54 – $157
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$91	$90	$21	23%	—	$44 – $106
24	Wellmark fee schedule · both · +1 other terms	13	$83	$85	$10	11%	—	$83 – $143
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$81	$90	$10	12%	—	$81 – $102

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