Toric or prism ballast hydrophilic contact 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

CNTCT LENS HYDROPHILIC TORIC

Payers reporting HCPCS V2521

Payer pricing summary

Low

$58

Average

$274

Median

$249

High

$834

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +14 other terms	340	$235	$231	$60	26%	—	$109 – $737
2	Aetna fee schedule · outpatient · +14 other terms	324	$237	$288	$150	52%	—	$98 – $1.5k
3	Humana fee schedule · outpatient · +14 other terms	316	$242	$358	$372	104%	—	$176 – $1.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	216	$233	$324	$277	85%	—	$0 – $1.6k
5	WellCare fee schedule · outpatient · +7 other terms	202	$243	$255	$62	24%	—	$218 – $578
6	Devoted fee schedule · outpatient · +2 other terms	164	$236	$236	$10	4%	—	$222 – $302
7	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$238	$240	$12	5%	—	$222 – $305
8	Molina fee schedule · outpatient · +10 other terms	112	$291	$322	$123	38%	—	$200 – $619
9	Cigna fee schedule · outpatient · +12 other terms	95	$240	$278	$103	37%	—	$218 – $869
10	Anthem fee schedule · outpatient · +12 other terms	75	$247	$281	$217	77%	—	$218 – $2.2k
11	Kaiser fee schedule · outpatient · +8 other terms	61	$252	$368	$255	69%	—	$222 – $1.6k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	41	$400	$440	$97	22%	—	$218 – $556
13	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$248	$248	$1	0%	—	$232 – $248
14	Clover fee schedule · outpatient · +2 other terms	37	$291	$263	$28	11%	—	$222 – $296
15	Oscar fee schedule · outpatient · +7 other terms	32	$233	$261	$52	20%	—	$232 – $378
16	Optum fee schedule · outpatient · +8 other terms	26	$238	$280	$109	39%	—	$222 – $591
17	Caresource facility · case rate · outpatient · +4 other terms	20	$332	$373	$67	18%	—	$216 – $593
18	Regence facility · fee schedule · outpatient · +3 other terms	19	$257	$242	$26	11%	—	$185 – $262
19	Bcbs Tx fee schedule · outpatient	18	$232	$232	—	—	—	$232 – $232
20	Medicare fee schedule · outpatient · +3 other terms	18	$238	$238	$2	1%	—	$238 – $242
21	Amerihealth Caritas fee schedule · outpatient · +2 other terms	16	$267	$264	$5	2%	—	$253 – $267
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$296	$339	$85	25%	—	$161 – $468
23	Tricare facility · fee schedule · outpatient · +2 other terms	14	$262	$261	$19	7%	—	$218 – $296
24	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$270	$269	$63	23%	—	$131 – $316
25	Wellmark fee schedule · both · +1 other terms	13	$233	$238	$31	13%	—	$233 – $426

Page 1 of 3 · 53 payers