Vision item or service not listed elsewhere

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER HCPCS VISION CODE

Payers reporting HCPCS V2797

Payer pricing summary

Low

Average

$139

Median

$92

High

$547

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Regence facility · other · outpatient · +3 other terms	2	$5	$5	$3	59%	2–20	$2 – $8
2	Anthem facility · case rate · outpatient · +7 other terms	15	$33	$36	$8	23%	—	$23 – $56
3	Caresource facility · case rate · outpatient · +2 other terms	15	$34	$36	$8	23%	—	$23 – $57
4	Molina facility · case rate · outpatient · +6 other terms	15	$33	$36	$8	23%	—	$23 – $56
5	UnitedHealthcare facility · case rate · outpatient · +7 other terms	15	$34	$37	$9	23%	—	$23 – $57
6	Aetna fee schedule · both · +11 other terms	13	$142	$142	$1	0%	—	$142 – $145
7	Wellmark fee schedule · both · +1 other terms	13	$106	$104	$13	12%	—	$26 – $106
8	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	12	$6	$14	$26	184%	—	$0 – $99
9	Cigna facility · fee schedule · outpatient · +8 other terms	12	$113	$61	$44	73%	—	$16 – $113
10	Optum facility · case rate · outpatient · +1 other terms	11	$31	$34	$8	22%	—	$28 – $51
11	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +3 other terms	10	$49	$81	$164	203%	—	$2 – $810
12	First Health facility · percent of total billed charges · inpatientfrom % of charges · +3 other terms	9	$49	$49	—	—	—	$49 – $49
13	Medica facility · percent of total billed charges · inpatientfrom % of charges · +2 other terms	9	$49	$50	$1	1%	—	$49 – $51
14	Sanford Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	9	$29	$29	—	—	—	$29 – $29
15	Bcbs Id percent of total billed charges · bothfrom % of charges · +1 other terms	4	$10	$11	$6	54%	—	$5 – $19
16	Humana facility · other · outpatient · +2 other terms	2	$49	$49	$7	15%	—	$42 – $56
17	Kaiser facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	2	$135	$135	—	—	—	$135 – $135
18	Bcbs Il professional · fee schedule · both	1	$26	$26	—	—	—	$26 – $26
19	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
20	Bcbs Nc facility · fee schedule · outpatient	1	$11	$11	—	—	—	$11 – $11
21	Bcbs Vt professional · fee schedule · outpatient	1	$242	$242	—	—	—	$242 – $242
22	Devoted facility · fee schedule · outpatient · +1 other terms	1	$90	$90	$127	140%	—	$1 – $270
23	Magellan fee schedule · outpatient	1	$2	$2	—	—	—	$2 – $2
24	Phcs facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	1	$271	$271	$381	140%	—	$2 – $810
25	WellCare percent of total billed charges · outpatientfrom % of charges	1	$220	$220	—	—	—	$220 – $220