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 sphere trifocal 4.12-7.
Dubuque, IA
See all hospitals reporting HCPCS V2301 →Price type
The Finley Hospital’s median price of $97 is 10% below the median hospital's median price ($107), higher than 27% of the 731 hospitals reporting HCPCS V2301. 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, 17 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 hmo fee schedule · both | $46 | $46 | — | — | — | $46 – $46 |
| 2 | UnitedHealthcare ppo fee schedule · both | $46 | $46 | — | — | — | $46 – $46 |
| 3 | Wellmark commercial fee schedule · both | $83 | $83 | — | — | — | $83 – $83 |
| 4 | Wellmark hmo fee schedule · both | $83 | $83 | — | — | — | $83 – $83 |
| 5 | Wellmark ppo fee schedule · both | $83 | $83 | — | — | — | $83 – $83 |
| 6 | Aetna hmo fee schedule · outpatient | $92 | $92 | — | — | — | $92 – $92 |
| 7 | Aetna ppo fee schedule · outpatient | $92 | $92 | — | — | — | $92 – $92 |
| 8 | Aetna medicare advantage case rate · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 9 | Molina medicare advantage case rate · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 10 | Wellmark medicare advantage case rate · outpatient | $94 | $94 | — | — | — | $94 – $94 |
| 11 | Humana medicare advantage case rate · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 13 | Aetna hmo fee schedule · both | $103 | $103 | — | — | — | $103 – $103 |
| 14 | Aetna ppo fee schedule · both | $103 | $103 | — | — | — | $103 – $103 |
| 15 | UnitedHealthcare hmo fee schedule · outpatient | $148 | $148 | — | — | — | $148 – $148 |
| 16 | UnitedHealthcare ppo fee schedule · outpatient | $148 | $148 | — | — | — | $148 – $148 |
| 17 | Cigna commercial fee schedule · both | $176 | $176 | — | — | — | $176 – $176 |
Last updated: Jan 28, 2026
See Trifocal spectacle lens, sphere power ±4.12 to ±7.00 diopters, per lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.