Trifocal spherocylinder lens, high power, 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/>6

Payers reporting HCPCS V2310

Payer pricing summary

Low

$28

Average

$138

Median

$127

High

$320

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +10 other terms	336	$111	$124	$28	23%	—	$51 – $362
2	Aetna fee schedule · outpatient · +11 other terms	321	$117	$140	$71	51%	—	$62 – $731
3	Humana fee schedule · outpatient · +9 other terms	316	$137	$175	$164	94%	—	$83 – $806
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$140	$152	$103	68%	—	$0 – $591
5	WellCare fee schedule · outpatient · +4 other terms	202	$111	$121	$24	20%	—	$103 – $222
6	Devoted fee schedule · outpatient · +2 other terms	164	$105	$114	$16	14%	—	$101 – $147
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$141	$117	$19	16%	—	$105 – $151
8	Molina fee schedule · outpatient · +5 other terms	109	$148	$148	$54	37%	—	$87 – $275
9	Cigna fee schedule · outpatient · +7 other terms	95	$131	$142	$44	31%	—	$101 – $327
10	Anthem fee schedule · outpatient · +6 other terms	74	$108	$121	$21	18%	—	$101 – $223
11	Kaiser fee schedule · outpatient · +4 other terms	61	$107	$172	$129	75%	—	$101 – $802
12	Superior Healthplan fee schedule · outpatient	40	$110	$110	$1	0%	—	$103 – $110
13	Clover fee schedule · outpatient · +2 other terms	37	$111	$123	$16	13%	—	$110 – $147
14	Oscar fee schedule · outpatient · +4 other terms	32	$138	$130	$28	21%	—	$103 – $182
15	Ambetter facility · fee schedule · outpatient · +5 other terms	30	$201	$247	$79	32%	—	$117 – $349
16	Optum fee schedule · outpatient · +4 other terms	26	$124	$133	$48	36%	—	$101 – $262
17	Caresource facility · case rate · outpatient · +4 other terms	20	$59	$105	$81	78%	—	$36 – $280
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$109	$107	$5	5%	—	$91 – $111
19	Bcbs Tx fee schedule · outpatient	18	$103	$103	—	—	—	$103 – $103
20	Medicare fee schedule · outpatient · +1 other terms	18	$101	$101	$1	1%	—	$101 – $103
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$168	$166	$3	2%	—	$159 – $168
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$111	$129	$32	25%	—	$61 – $176
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$101	$101	$24	23%	—	$49 – $119
24	Wellmark fee schedule · both · +1 other terms	13	$93	$94	$11	11%	—	$93 – $160
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$91	$110	$23	21%	—	$91 – $137

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