Glass or plastic prism 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

Glass/plastic slab off prism

Payers reporting HCPCS V2710

Payer pricing summary

Low

$21

Average

$107

Median

$96

High

$295

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +11 other terms	337	$93	$88	$19	22%	—	$38 – $260
2	Aetna fee schedule · outpatient · +10 other terms	322	$94	$106	$58	54%	—	$35 – $644
3	Humana fee schedule · outpatient · +9 other terms	316	$93	$139	$156	112%	—	$62 – $749
4	WellCare fee schedule · outpatient · +4 other terms	202	$95	$98	$21	22%	—	$77 – $204
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	201	$95	$115	$85	74%	—	$0 – $477
6	Devoted fee schedule · outpatient · +2 other terms	164	$93	$93	$8	8%	—	$79 – $107
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$95	$94	$6	7%	—	$79 – $108
8	Molina fee schedule · outpatient · +5 other terms	109	$120	$130	$52	40%	—	$77 – $255
9	Cigna fee schedule · outpatient · +7 other terms	95	$93	$100	$32	32%	—	$77 – $264
10	Anthem fee schedule · outpatient · +7 other terms	74	$93	$93	$15	16%	—	$77 – $180
11	Kaiser fee schedule · outpatient · +4 other terms	61	$97	$139	$91	65%	—	$79 – $576
12	Superior Healthplan fee schedule · outpatient	40	$102	$102	$0	0%	—	$95 – $102
13	Clover fee schedule · outpatient · +2 other terms	37	$103	$96	$10	10%	—	$79 – $105
14	Oscar fee schedule · outpatient · +3 other terms	32	$95	$104	$27	26%	—	$82 – $168
15	Ambetter facility · fee schedule · outpatient · +5 other terms	30	$162	$161	$29	18%	—	$77 – $196
16	Optum fee schedule · outpatient · +3 other terms	26	$91	$105	$48	46%	—	$79 – $243
17	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$68	$64	94%	—	$20 – $209
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$98	$91	$13	14%	—	$65 – $100
19	Bcbs Tx fee schedule · outpatient	18	$95	$95	—	—	—	$95 – $95
20	Medicare fee schedule · outpatient · +1 other terms	18	$91	$91	$1	1%	—	$91 – $93
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$94	$93	$2	2%	—	$89 – $94
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$90	$104	$26	25%	—	$49 – $142
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$82	$82	$19	23%	—	$40 – $96
24	Wellmark fee schedule · both · +1 other terms	13	$82	$83	$8	9%	—	$82 – $129
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$74	$75	$2	2%	—	$74 – $77

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