Trifocal spherocylinder eyeglass 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 trifo 7.25-12/.25-

Payers reporting HCPCS V2311

Payer pricing summary

Low

$34

Average

$147

Median

$130

High

$308

Payer rate distribution

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Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +10 other terms	336	$132	$126	$26	21%	—	$53 – $362
2	Aetna fee schedule · outpatient · +11 other terms	321	$132	$147	$75	51%	—	$59 – $856
3	Humana fee schedule · outpatient · +9 other terms	316	$132	$196	$208	106%	—	$87 – $1.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	211	$136	$165	$116	70%	—	$0 – $683
5	WellCare fee schedule · outpatient · +4 other terms	202	$135	$136	$17	12%	—	$107 – $214
6	Devoted fee schedule · outpatient · +2 other terms	164	$131	$129	$9	7%	—	$105 – $148
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$134	$132	$8	6%	—	$109 – $150
8	Molina fee schedule · outpatient · +5 other terms	109	$155	$176	$68	39%	—	$91 – $343
9	Cigna fee schedule · outpatient · +7 other terms	95	$137	$141	$41	29%	—	$105 – $377
10	Anthem fee schedule · outpatient · +6 other terms	74	$120	$124	$24	19%	—	$105 – $257
11	Kaiser fee schedule · outpatient · +4 other terms	61	$111	$180	$131	73%	—	$105 – $801
12	Superior Healthplan fee schedule · outpatient	40	$138	$138	$1	0%	—	$129 – $138
13	Clover fee schedule · outpatient · +2 other terms	37	$133	$124	$15	12%	—	$107 – $145
14	Ambetter facility · fee schedule · outpatient · +5 other terms	32	$232	$251	$61	24%	—	$131 – $333
15	Oscar fee schedule · outpatient · +4 other terms	32	$140	$148	$31	21%	—	$128 – $223
16	Optum fee schedule · outpatient · +4 other terms	26	$123	$141	$66	47%	—	$105 – $328
17	Caresource facility · case rate · outpatient · +4 other terms	20	$59	$107	$85	80%	—	$36 – $291
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$113	$110	$7	7%	—	$91 – $116
19	Bcbs Tx fee schedule · outpatient	18	$129	$129	—	—	—	$129 – $129
20	Medicare fee schedule · outpatient · +1 other terms	18	$105	$105	$1	1%	—	$105 – $107
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$160	$158	$3	2%	—	$152 – $160
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$129	$148	$37	25%	—	$70 – $203
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$117	$117	$27	23%	—	$57 – $137
24	Wellmark fee schedule · both · +1 other terms	13	$96	$99	$14	14%	—	$96 – $185
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$105	$116	$13	11%	—	$105 – $131

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