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/12-2.00d
Edina, MN
See all hospitals reporting HCPCS V2103 →Price type
Fairview Health Services’s median price of $61 is 27% above the median hospital's median price ($48), higher than 82% of the 734 hospitals reporting HCPCS V2103. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 29 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 | Bcbs Mn pmap fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 2 | Bcbs Mn aware federal fee schedule · both | $44 | $44 | — | — | — | $44 – $44 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $44 | $44 | — | — | — | $44 – $44 |
| 4 | Sanford Health Plan medicare advantage fee schedule · outpatient | $46 | $46 | — | — | — | $46 – $46 |
| 5 | UnitedHealthcare medicare advantage fee schedule · outpatient | $46 | $46 | — | — | — | $46 – $46 |
| 6 | WellCare medicare advantage fee schedule · outpatient | $46 | $46 | — | — | — | $46 – $46 |
| 7 | Ucare medicare advantage/msho fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 8 | Bcbs Mn medicare advantage fee schedule · outpatient | $48 | $48 | — | — | — | $48 – $48 |
| 9 | Medica medicare advantage non-snp fee schedule · outpatient | $49 | $49 | — | — | — | $49 – $49 |
| 10 | Medica medicare advantage non-snp fee schedule · both | $50 | $50 | — | — | — | $50 – $50 |
| 11 | Bcbs Mn aware federal fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 12 | Medica msho/medicare advantage snp fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 13 | Bcbs Mn aware/blue plus fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 14 | Medica managed medicaid/accessability fee schedule · outpatient | $56 | $56 | — | — | — | $56 – $56 |
| 15 | Medica msho/medicare advantage snp fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 16 | Ucare individual and family with m health fairview fee schedule · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 17 | UnitedHealthcare commercial fee schedule · both | $85 | $85 | — | — | — | $85 – $85 |
| 18 | UnitedHealthcare core fee schedule · both | $85 | $85 | — | — | — | $85 – $85 |
| 19 | Medica bold fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 20 | Medica vantage self insured fee schedule · both | $94 | $94 | — | — | — | $94 – $94 |
| 21 | Medica city of st. paul/essential-uplan fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 22 | Medica individual and family business except aco fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 23 | Medica choice fee schedule · both | $99 | $99 | — | — | — | $99 – $99 |
| 24 | Medica bold fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 25 | Ucare individual and family fee schedule · outpatient | $106 | $106 | — | — | — | $106 – $106 |
Last updated: Feb 6, 2026
See Single-vision eyeglass lens, plano to ±4.00 diopter sphere pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.