Bifocal eyeglass lens, high power

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 bifocal over 12.

Payers reporting HCPCS V2214

Payer pricing summary

Low

$29

Average

$133

Median

$117

High

$370

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$113	$115	$25	22%	—	$27 – $355
2	Aetna fee schedule · outpatient · +12 other terms	321	$114	$135	$73	54%	—	$49 – $730
3	Humana fee schedule · outpatient · +9 other terms	316	$116	$164	$161	98%	—	$82 – $789
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$114	$138	$96	69%	—	$0 – $552
5	WellCare fee schedule · outpatient · +4 other terms	202	$110	$114	$27	24%	—	$100 – $256
6	Devoted fee schedule · outpatient · +2 other terms	164	$112	$107	$6	6%	—	$103 – $139
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$120	$110	$11	10%	—	$103 – $142
8	Molina fee schedule · outpatient · +5 other terms	109	$146	$144	$54	37%	—	$100 – $269
9	Cigna fee schedule · outpatient · +6 other terms	95	$117	$134	$44	33%	—	$101 – $329
10	Anthem fee schedule · outpatient · +6 other terms	74	$117	$122	$17	14%	—	$101 – $208
11	Kaiser fee schedule · outpatient · +4 other terms	61	$122	$178	$123	69%	—	$107 – $785
12	Superior Healthplan fee schedule · outpatient	40	$108	$108	$1	0%	—	$101 – $108
13	Clover fee schedule · outpatient · +2 other terms	37	$129	$121	$9	7%	—	$108 – $137
14	Oscar fee schedule · outpatient · +3 other terms	32	$117	$121	$29	24%	—	$100 – $192
15	Ambetter facility · fee schedule · outpatient · +5 other terms	30	$187	$211	$52	25%	—	$101 – $280
16	Optum fee schedule · outpatient · +3 other terms	26	$115	$130	$45	34%	—	$100 – $256
17	Caresource facility · case rate · outpatient · +4 other terms	20	$59	$102	$78	76%	—	$36 – $273
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$124	$117	$13	11%	—	$89 – $127
19	Bcbs Tx fee schedule · outpatient	18	$101	$101	—	—	—	$101 – $101
20	Medicare fee schedule · outpatient · +1 other terms	18	$115	$115	$1	1%	—	$115 – $117
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$134	$133	$3	2%	—	$128 – $134
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$104	$120	$30	25%	—	$57 – $164
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$95	$95	$22	23%	—	$46 – $111
24	Wellmark fee schedule · both · +1 other terms	13	$93	$95	$9	10%	—	$93 – $149
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$85	$95	$12	13%	—	$85 – $110

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