Trifocal spherocylinder lens, 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 sphc trifocal 4.25-7/2.

Payers reporting HCPCS V2308

Payer pricing summary

Low

$27

Average

$126

Median

$110

High

$306

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +12 other terms	336	$108	$109	$24	22%	—	$48 – $367
2	Aetna fee schedule · outpatient · +12 other terms	321	$109	$128	$70	54%	—	$48 – $740
3	Humana fee schedule · outpatient · +9 other terms	316	$109	$159	$161	101%	—	$77 – $787
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$111	$136	$94	69%	—	$0 – $541
5	WellCare fee schedule · outpatient · +4 other terms	202	$106	$111	$19	17%	—	$98 – $212
6	Devoted fee schedule · outpatient · +2 other terms	164	$102	$104	$5	4%	—	$96 – $132
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$112	$107	$8	8%	—	$100 – $134
8	Molina fee schedule · outpatient · +5 other terms	109	$134	$142	$53	37%	—	$83 – $268
9	Cigna fee schedule · outpatient · +6 other terms	95	$112	$126	$40	32%	—	$96 – $299
10	Anthem fee schedule · outpatient · +6 other terms	74	$100	$112	$18	16%	—	$96 – $204
11	Kaiser fee schedule · outpatient · +4 other terms	61	$102	$170	$132	78%	—	$96 – $812
12	Superior Healthplan fee schedule · outpatient	40	$107	$107	$1	0%	—	$100 – $107
13	Clover fee schedule · outpatient · +2 other terms	37	$107	$109	$4	4%	—	$106 – $130
14	Ambetter facility · fee schedule · outpatient · +5 other terms	32	$183	$204	$50	25%	—	$106 – $272
15	Oscar fee schedule · outpatient · +3 other terms	32	$114	$118	$25	21%	—	$100 – $178
16	Optum fee schedule · outpatient · +3 other terms	26	$105	$120	$48	40%	—	$95 – $256
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$80	$83	104%	—	$20 – $260
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$104	$104	$4	3%	—	$92 – $106
19	Bcbs Tx fee schedule · outpatient	18	$100	$100	—	—	—	$100 – $100
20	Medicare fee schedule · outpatient · +1 other terms	18	$96	$97	$1	1%	—	$96 – $98
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$130	$129	$3	2%	—	$124 – $130
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$102	$118	$29	25%	—	$55 – $161
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$93	$93	$22	23%	—	$45 – $109
24	Wellmark fee schedule · both · +1 other terms	13	$86	$88	$10	11%	—	$86 – $146
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$83	$93	$11	12%	—	$83 – $106

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