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

Blue Cross Blue Shield pricing summary

Low

Average

$53

Median

$37

High

$728

Blue Cross Blue Shield rate distribution

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37 hospital rates

#		Plans
1	Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient	4	$1	$1	$0	43%	—	$0 – $1
2	Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient	1	$82	$82	—	—	—	$82 – $82
3	Duncan Regional Hospital Duncan, OK case rate · outpatient	5	$17	$17	—	—	—	$17 – $17
4	Edward Hospital Plainfield, IL fee schedule · outpatient	1	$57	$57	—	—	—	$57 – $57
5	Elmhurst Memorial Hospital Elmhurst, IL fee schedule · outpatient	1	$57	$57	—	—	—	$57 – $57
6	Endeavor Health Clinical Operations Skokie, IL fee schedule · outpatient	3	$91	$91	$6	7%	—	$84 – $99
7	Evans Memorial Hospital Claxton, GA percent of total billed charges · outpatientfrom % of charges	2	$733	$728	$175	24%	—	$464 – $1.2k
8	Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient	2	$2	$2	—	—	—	$2 – $2
9	HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient	1	$41	$41	$0	1%	—	$41 – $42
10	Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
11	Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient	1	$41	$41	$0	1%	—	$41 – $42
12	Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
13	Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
14	Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
15	Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
16	Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient	1	$42	$42	—	—	—	$42 – $42
17	Jefferson County Hospital OK Waurika, OK case rate · outpatient	5	$17	$17	—	—	—	$17 – $17
18	Northwest Community Hospital Arlington Heights, IL fee schedule · outpatient	2	$37	$37	$2	6%	—	$34 – $39
19	Phoenix Children's Hospital Phoenix, AZ facility · fee schedule · outpatient	1	$86	$86	—	—	—	$86 – $86
20	RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA fee schedule · outpatient	2	$0	$0	—	—	—	$0 – $0
21	St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · bothfrom % of charges	1	$12	$12	$6	52%	—	$6 – $19
22	St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID percent of total billed charges · outpatientfrom % of charges	2	$12	$12	$6	52%	—	$6 – $18
23	St Luke's McCall, LTD McCall, ID percent of total billed charges · outpatientfrom % of charges	2	$10	$11	$6	55%	—	$4 – $19
24	St Luke's Nampa Medical Center, LTD Nampa, ID percent of total billed charges · bothfrom % of charges	1	$12	$12	$6	52%	—	$6 – $19
25	St Luke's Nampa Medical Center, LTD Nampa, ID percent of total billed charges · outpatientfrom % of charges	2	$12	$12	$6	52%	—	$6 – $18

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HCPCS V2797