Polarized lens treatment, 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

Polarization, any lens

Payers reporting HCPCS V2762

Payer pricing summary

Low

$15

Average

$89

Median

$77

High

$250

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	299	$74	$113	$118	105%	—	$52 – $568
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	287	$74	$71	$10	14%	—	$32 – $90
3	Aetna fee schedule · outpatient · +12 other terms	274	$74	$89	$57	65%	—	$33 – $443
4	WellCare fee schedule · outpatient · +4 other terms	181	$76	$78	$12	15%	—	$70 – $140
5	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	170	$74	$92	$72	77%	—	$0 – $389
6	Devoted fee schedule · outpatient · +2 other terms	163	$74	$74	$2	2%	—	$71 – $89
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$75	$75	$3	3%	—	$74 – $90
8	Molina fee schedule · outpatient · +4 other terms	95	$105	$101	$39	39%	—	$62 – $193
9	Cigna fee schedule · outpatient · +7 other terms	86	$75	$80	$26	33%	—	$27 – $215
10	Anthem fee schedule · outpatient · +7 other terms	73	$73	$75	$7	10%	—	$70 – $117
11	Superior Healthplan fee schedule · outpatient	40	$77	$77	$0	0%	—	$72 – $77
12	Kaiser fee schedule · outpatient · +4 other terms	39	$73	$74	$3	3%	—	$71 – $86
13	Clover fee schedule · outpatient · +1 other terms	37	$74	$74	$4	5%	—	$70 – $87
14	Optum fee schedule · outpatient · +1 other terms	25	$73	$85	$36	42%	—	$71 – $184
15	Oscar fee schedule · outpatient · +2 other terms	24	$72	$74	$3	3%	—	$72 – $78
16	Caresource facility · case rate · outpatient · +4 other terms	20	$32	$61	$52	85%	—	$20 – $175
17	Bcbs Tx fee schedule · outpatient	18	$72	$72	—	—	—	$72 – $72
18	Medicare fee schedule · outpatient	18	$71	$72	$1	1%	—	$71 – $73
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	16	$89	$88	$2	2%	—	$84 – $89
20	Wellmark fee schedule · both · +1 other terms	13	$64	$66	$7	10%	—	$64 – $105
21	Aetna Better Health fee schedule · outpatient · +2 other terms	12	$60	$65	$6	9%	—	$60 – $72
22	Ambetter case rate · outpatient · +5 other terms	12	$104	$109	$9	8%	—	$104 – $137
23	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$64	$65	$17	26%	—	$32 – $78
24	Bcbs Nj fee schedule · outpatient	12	$70	$152	$103	68%	—	$70 – $311
25	Highmark fee schedule · outpatient · +4 other terms	10	$74	$76	$27	36%	—	$33 – $168

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