Ultraviolet-blocking intraocular 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

UV lens/es

Payers reporting HCPCS V2755

Payer pricing summary

Low

Average

$27

Median

$25

High

$60

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +11 other terms	337	$23	$23	$5	24%	—	$10 – $72
2	Aetna fee schedule · outpatient · +10 other terms	322	$23	$27	$13	48%	—	$10 – $146
3	Humana fee schedule · outpatient · +9 other terms	316	$23	$38	$44	116%	—	$14 – $209
4	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	212	$27	$30	$19	63%	—	$0 – $109
5	WellCare fee schedule · outpatient · +4 other terms	202	$24	$27	$4	14%	—	$20 – $40
6	Devoted fee schedule · outpatient · +2 other terms	164	$23	$25	$3	10%	—	$20 – $29
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$24	$26	$2	8%	—	$21 – $28
8	Molina fee schedule · outpatient · +5 other terms	109	$30	$35	$15	41%	—	$18 – $71
9	Cigna fee schedule · outpatient · +7 other terms	95	$24	$25	$6	25%	—	$21 – $60
10	Anthem fee schedule · outpatient · +7 other terms	74	$21	$23	$4	16%	—	$20 – $41
11	Kaiser fee schedule · outpatient · +4 other terms	61	$22	$34	$26	75%	—	$21 – $160
12	Superior Healthplan fee schedule · outpatient	40	$28	$28	$0	0%	—	$27 – $28
13	Clover fee schedule · outpatient · +2 other terms	37	$23	$23	$3	14%	—	$20 – $28
14	Oscar fee schedule · outpatient · +3 other terms	32	$27	$27	$4	15%	—	$24 – $36
15	Ambetter facility · fee schedule · outpatient · +5 other terms	31	$37	$42	$11	26%	—	$22 – $57
16	Optum fee schedule · outpatient · +3 other terms	26	$21	$26	$14	55%	—	$20 – $68
17	Caresource facility · case rate · outpatient · +4 other terms	20	$11	$20	$16	78%	—	$7 – $54
18	Regence facility · fee schedule · outpatient · +1 other terms	19	$22	$22	$1	6%	—	$18 – $23
19	Bcbs Tx fee schedule · outpatient	18	$27	$27	—	—	—	$27 – $27
20	Medicare fee schedule · outpatient · +1 other terms	18	$21	$21	$0	1%	—	$21 – $21
21	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$27	$27	$1	2%	—	$26 – $27
22	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$21	$24	$6	25%	—	$11 – $32
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$19	$19	$4	23%	—	$9 – $22
24	Wellmark fee schedule · both · +1 other terms	13	$18	$18	$2	10%	—	$18 – $29
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$17	$19	$3	14%	—	$17 – $22

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