HCPCS V2105

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Current code21 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS V2105 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$59.27 – $65.206 plans——
Deaconess Medical CenterSpokaneFile dated 2026-08-27$59.27 – $65.208 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$60.48 – $72.587 plans——
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$59.27 – $65.207 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$59.27 – $65.207 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$59.27 – $65.207 plans——
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$59.27 – $65.207 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$61.05 – $65.207 plans——
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$60.48 – $62.903 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$60.48 – $72.587 plans——
Providence Centralia HospitalCentraliaFile dated 2026-04-01$60.48 – $96.777 plans——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$60.48 – $66.536 plans——
Providence St Peter HospitalOlympiaFile dated 2026-04-01$60.48 – $96.777 plans——
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$60.48 – $72.588 plans——
Swedish IssaquahIssaquahFile dated 2026-04-01$60.48 – $72.588 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$60.48 – $72.588 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$60.48 – $72.588 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$59.27 – $65.207 plans——
Virginia Mason Medical CenterSeattle$41.50 – $62.259 plans——
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27$59.27 – $66.388 plans——

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$60.48 (fee)