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
Marshalltown, IA
See all hospitals reporting HCPCS V2104 →Price type
UnityPoint Health Marshalltown’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, 15 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 | $23 | $23 | — | — | — | $23 – $23 |
| 2 | UnitedHealthcare ppo fee schedule · both | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Wellmark commercial fee schedule · both | $41 | $41 | — | — | — | $41 – $41 |
| 4 | Wellmark hmo fee schedule · both | $41 | $41 | — | — | — | $41 – $41 |
| 5 | Wellmark ppo fee schedule · both | $41 | $41 | — | — | — | $41 – $41 |
| 6 | Aetna hmo fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 7 | Aetna ppo fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 8 | Aetna medicare advantage case rate · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 9 | Molina medicare advantage case rate · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 10 | Wellmark medicare advantage case rate · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 11 | Humana medicare advantage case rate · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 13 | UnitedHealthcare hmo fee schedule · outpatient | $72 | $72 | — | — | — | $72 – $72 |
| 14 | UnitedHealthcare ppo fee schedule · outpatient | $72 | $72 | — | — | — | $72 – $72 |
| 15 | Cigna commercial fee schedule · both | $86 | $86 | — | — | — | $86 – $86 |
Last updated: Jan 28, 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.