Trifocal 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 sphcy trifocal 4.25-7/.

Payers reporting HCPCS V2307

Payer pricing summary

Low

$28

Average

$120

Median

$106

High

$305

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$102	$104	$22	21%	—	$45 – $331
2	Aetna fee schedule · outpatient · +12 other terms	321	$103	$122	$66	54%	—	$45 – $672
3	Humana fee schedule · outpatient · +9 other terms	316	$104	$152	$155	102%	—	$74 – $757
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$104	$129	$86	67%	—	$0 – $496
5	WellCare fee schedule · outpatient · +4 other terms	202	$102	$106	$20	19%	—	$90 – $212
6	Devoted fee schedule · outpatient · +2 other terms	164	$98	$99	$4	4%	—	$92 – $126
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$105	$102	$7	7%	—	$96 – $128
8	Molina fee schedule · outpatient · +5 other terms	109	$129	$136	$51	37%	—	$80 – $258
9	Cigna fee schedule · outpatient · +7 other terms	95	$105	$119	$38	32%	—	$92 – $274
10	Anthem fee schedule · outpatient · +6 other terms	74	$96	$107	$18	17%	—	$92 – $187
11	Kaiser fee schedule · outpatient · +4 other terms	61	$98	$160	$119	74%	—	$92 – $732
12	Superior Healthplan fee schedule · outpatient	40	$103	$103	$1	0%	—	$96 – $103
13	Clover fee schedule · outpatient · +2 other terms	37	$106	$106	$3	3%	—	$102 – $124
14	Ambetter facility · fee schedule · outpatient · +5 other terms	32	$168	$194	$45	23%	—	$100 – $254
15	Oscar fee schedule · outpatient · +4 other terms	32	$107	$114	$28	24%	—	$96 – $183
16	Optum fee schedule · outpatient · +4 other terms	26	$100	$114	$46	40%	—	$90 – $246
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$77	$79	102%	—	$20 – $248
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$100	$98	$5	5%	—	$83 – $102
19	Bcbs Tx fee schedule · outpatient	18	$96	$96	—	—	—	$96 – $96
20	Medicare fee schedule · outpatient · +1 other terms	18	$92	$93	$1	1%	—	$92 – $94
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$122	$121	$2	2%	—	$116 – $122
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$93	$108	$27	25%	—	$51 – $148
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$85	$85	$20	23%	—	$41 – $100
24	Wellmark fee schedule · both · +1 other terms	13	$82	$83	$8	10%	—	$82 – $134
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$76	$86	$12	13%	—	$76 – $100

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