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
Grayling, MI
See all hospitals reporting HCPCS V2104 →Price type
Munson Healthcare Grayling’s median price of $61 is 13% above the median hospital's median price ($54), higher than 75% 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: 6 payers, 12 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 | $23 | $23 | — | — | — | $23 – $23 |
| 2 | UnitedHealthcare medicare advantage professional · fee schedule · both | $31 | $31 | — | — | — | $31 – $31 |
| 3 | Blue Cross Blue Shield managed medicaid facility · fee schedule · outpatient | $32 | $32 | — | — | — | $32 – $32 |
| 4 | Molina managed medicaid facility · fee schedule · outpatient | $32 | $32 | — | — | — | $32 – $32 |
| 5 | UnitedHealthcare managed medicaid facility · fee schedule · outpatient | $32 | $32 | — | — | — | $32 – $32 |
| 6 | Aetna commercial professional · fee schedule · both | $43 | $43 | — | — | — | $43 – $43 |
| 7 | Blue Cross Blue Shield commercial professional · fee schedule · both | $56 | $56 | — | — | — | $56 – $56 |
| 8 | Aetna medicare advantage facility · fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 9 | Humana medicare advantage facility · fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 10 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 11 | WellCare medicare advantage facility · fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 12 | Molina medicare advantage facility · fee schedule · outpatient | $66 | $66 | — | — | — | $66 – $66 |
Last updated: Apr 17, 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.