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.
Original text from hospital filings
VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT OF ANOTHER HCPCS VISION CODE
Low
$12
Average
$97
Median
$49
High
$898
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
41 hospitals; the 90th percentile is 16.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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53 hospital rates
iThe hospitals that file a Cigna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 2 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 3 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $270 | $270 | — | — | — | $270 – $270 |
| 4 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $17 | $17 | $1 | 4% | — | $16 – $18 |
| 5 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 6 | Evans Memorial Hospital Claxton, GA percent of total billed charges · inpatientfrom % of charges | 1 | $965 | $958 | $230 | 24% | — | $611 – $1.5k |
| 7 | Evans Memorial Hospital Claxton, GA percent of total billed charges · outpatientfrom % of charges | 1 | $843 | $837 | $201 | 24% | — | $534 – $1.3k |
| 8 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 9 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · fee schedule · outpatient | 3 | $24 | $23 | $2 | 10% | — | $20 – $25 |
| 10 | La Porte Hospital Company LLC La Porte, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $224 | $315 | 140% | — | $1 – $669 |
| 11 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · fee schedule · outpatient | 3 | $21 | $21 | $5 | 23% | — | $16 – $28 |
| 12 | Maine Coast Regional Health Facilities Ellsworth, ME facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 13 | MaineHealth Rockport, ME percent of total billed charges · inpatientfrom % of charges | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 14 | MaineHealth Rockport, ME percent of total billed charges · outpatientfrom % of charges | 1 | $380 | $380 | — | — | — | $380 – $380 |
| 15 | MaineHealth Belfast, ME percent of total billed charges · inpatientfrom % of charges | 1 | $485 | $485 | — | — | — | $485 – $485 |
| 16 | MaineHealth Belfast, ME percent of total billed charges · outpatientfrom % of charges | 1 | $485 | $485 | — | — | — | $485 – $485 |
| 17 | Marshfield Medical Center - Eau Claire Eau Claire, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 18 | Marshfield Medical Center - Eau Claire Eau Claire, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 19 | Marshfield Medical Center - Ladysmith Ladysmith, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 20 | Marshfield Medical Center - Ladysmith Ladysmith, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 21 | Marshfield Medical Center - Marshfield Marshfield, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 22 | Marshfield Medical Center - Marshfield Marshfield, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 23 | Marshfield Medical Center - Minocqua Minocqua, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 24 | Marshfield Medical Center - Minocqua Minocqua, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 25 | Marshfield Medical Center - Neillsville Neillsville, WI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $48 | $48 | — | — | — | $48 – $48 |
← Payers reporting HCPCS V2797 · Snapshot 20261111T120946Z-9134e7f7