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
Spherocylindr 4.00d/2.12-4d
Boulder, CO
See all hospitals reporting HCPCS V2104 →Price type
Boulder Community Health’s median price of $64 is 18% above the median hospital's median price ($54), higher than 81% of the 732 hospitals reporting HCPCS V2104. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 19 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 | UnitedHealthcare commercial professional · fee schedule · both | $35 | $35 | — | — | — | $35 – $35 |
| 2 | Aetna medicare advantage professional · fee schedule · both | $49 | $49 | — | — | — | $49 – $49 |
| 3 | UnitedHealthcare medicare advantage professional · fee schedule · both | $53 | $53 | $6 | 11% | — | $47 – $59 |
| 4 | Aetna medicare advantage facility · case rate · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 5 | Anthem medicare advantage facility · case rate · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 6 | Humana medicare advantage professional · fee schedule · both | $59 | $59 | — | — | — | $59 – $59 |
| 7 | Humana medicare advantage facility · case rate · outpatient | $60 | $60 | — | — | — | $60 – $60 |
| 8 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $60 | $60 | — | — | — | $60 – $60 |
| 9 | Kaiser medicare advantage facility · case rate · outpatient | $60 | $60 | $0 | 0% | — | $60 – $61 |
| 10 | Devoted medicare advantage facility · case rate · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 11 | Kaiser medicare advantage professional · fee schedule · both | $63 | $63 | — | — | — | $63 – $63 |
| 12 | Aetna commercial professional · fee schedule · both | $71 | $71 | $22 | 31% | — | $49 – $92 |
| 13 | Kaiser commercial professional · fee schedule · both | $75 | $75 | — | — | — | $75 – $75 |
| 14 | MultiPlan commercial professional · fee schedule · both | $90 | $90 | — | — | — | $90 – $90 |
| 15 | Phcs commercial professional · fee schedule · both | $90 | $90 | — | — | — | $90 – $90 |
| 16 | Anthem commercial professional · fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 17 | Anthem managed care professional · fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 18 | Kaiser commercial facility · case rate · outpatient | $128 | $128 | $16 | 12% | — | $113 – $144 |
| 19 | Kaiser managed care facility · case rate · outpatient | $142 | $142 | — | — | — | $142 – $142 |
Last updated: Sep 16, 2026
See Single-vision spherocylinder eyeglass lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.