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 sphcy trifocal 4.0/.12-
Dubuque, IA
See all hospitals reporting HCPCS V2303 →Price type
The Finley Hospital’s median price of $81 is 10% below the median hospital's median price ($90), higher than 10% of the 733 hospitals reporting HCPCS V2303. 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 | $38 | $38 | — | — | — | $38 – $38 |
| 2 | UnitedHealthcare ppo fee schedule · both | $38 | $38 | — | — | — | $38 – $38 |
| 3 | Wellmark commercial fee schedule · both | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Wellmark hmo fee schedule · both | $69 | $69 | — | — | — | $69 – $69 |
| 5 | Wellmark ppo fee schedule · both | $69 | $69 | — | — | — | $69 – $69 |
| 6 | Aetna hmo fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 7 | Aetna ppo fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 8 | Aetna medicare advantage case rate · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 9 | Molina medicare advantage case rate · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 10 | Wellmark medicare advantage case rate · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 11 | Humana medicare advantage case rate · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 13 | Aetna hmo fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 14 | Aetna ppo fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
| 15 | UnitedHealthcare hmo fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 16 | UnitedHealthcare ppo fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 17 | Cigna commercial fee schedule · both | $147 | $147 | — | — | — | $147 – $147 |
Last updated: Jan 28, 2026
See Trifocal eyeglass lens, per lens pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.