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
Lenticular lens, single
Boulder, CO
See all hospitals reporting HCPCS V2121 →Price type
Boulder Community Health’s median price of $100 is 4% below the median hospital's median price ($104), higher than 40% of the 723 hospitals reporting HCPCS V2121. 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 | $57 | $57 | — | — | — | $57 – $57 |
| 2 | Aetna medicare advantage professional · fee schedule · both | $80 | $80 | — | — | — | $80 – $80 |
| 3 | UnitedHealthcare medicare advantage professional · fee schedule · both | $86 | $86 | $10 | 11% | — | $77 – $96 |
| 4 | Aetna medicare advantage facility · case rate · outpatient | $96 | $96 | — | — | — | $96 – $96 |
| 5 | Anthem medicare advantage facility · case rate · outpatient | $96 | $96 | — | — | — | $96 – $96 |
| 6 | Humana medicare advantage professional · fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 7 | Humana medicare advantage facility · case rate · outpatient | $98 | $98 | — | — | — | $98 – $98 |
| 8 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $98 | $98 | — | — | — | $98 – $98 |
| 9 | Kaiser medicare advantage facility · case rate · outpatient | $98 | $98 | $0 | 0% | — | $98 – $99 |
| 10 | Devoted medicare advantage facility · case rate · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 11 | Anthem commercial professional · fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 12 | Anthem managed care professional · fee schedule · both | $100 | $100 | — | — | — | $100 – $100 |
| 13 | Kaiser medicare advantage professional · fee schedule · both | $103 | $103 | — | — | — | $103 – $103 |
| 14 | Aetna commercial professional · fee schedule · both | $115 | $115 | $35 | 31% | — | $80 – $150 |
| 15 | Kaiser commercial professional · fee schedule · both | $123 | $123 | — | — | — | $123 – $123 |
| 16 | MultiPlan commercial professional · fee schedule · both | $147 | $147 | — | — | — | $147 – $147 |
| 17 | Phcs commercial professional · fee schedule · both | $147 | $147 | — | — | — | $147 – $147 |
| 18 | Kaiser commercial facility · case rate · outpatient | $209 | $209 | $25 | 12% | — | $184 – $234 |
| 19 | Kaiser managed care facility · case rate · outpatient | $232 | $232 | — | — | — | $232 – $232 |
Last updated: Sep 16, 2026
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