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
Lens sphcy bifocal 4.00d/2.1
Devils Lake, ND
See all hospitals reporting HCPCS V2204 →Price type
Altru Hospital Devils Lake’s median price of $70 is 4% below the median hospital's median price ($73), higher than 31% of the 732 hospitals reporting HCPCS V2204. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica medicaid managed care plan facility · fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $41 | $41 | — | — | — | $41 – $41 |
| 4 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 5 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 6 | Medica all commercial plans facility · fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 7 | Aetna medicare managed care plan facility · fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $95 | $95 | $14 | 15% | — | $81 – $109 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $99 | $99 | $26 | 26% | — | $73 – $126 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
Last updated: Mar 1, 2026
See Bifocal eyeglass lens with sphere and cylinder correction pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.