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 trifocal 4.0/2.25
Devils Lake, ND
See all hospitals reporting HCPCS V2304 →Price type
Altru Hospital Devils Lake’s median price of $90 is 2% below the median hospital's median price ($92), higher than 35% of the 730 hospitals reporting HCPCS V2304. 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 | $28 | $28 | — | — | — | $28 – $28 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 4 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 5 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 6 | Medica all commercial plans facility · fee schedule · outpatient | $84 | $84 | — | — | — | $84 – $84 |
| 7 | Aetna medicare managed care plan facility · fee schedule · outpatient | $90 | $90 | — | — | — | $90 – $90 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $124 | $124 | $18 | 15% | — | $105 – $142 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $129 | $129 | $34 | 26% | — | $95 – $163 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $177 | $177 | — | — | — | $177 – $177 |
Last updated: Mar 1, 2026
See Trifocal spherocylinder lens, per lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.