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For Dental Schedule of Extras, click on the following: |
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| EYEGLASSES | Single Vision |
Multifocal |
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| Gradient Tint (Plastic) | $15 | $15 |
| Double Gradient Tint (Plastic) | $22 | $22 |
| Photochromatic (Glass) | $80 | $100 |
| Photochromatic (Plastic) Transitions | $80 | $100 |
| Solid Tint (Plastic) (Other than #1 Tint, Included) |
$15 | $15 |
| Polish Edges (Plastic) | $20 | $20 |
| AR-cote (Generic) | $42 | $42 |
| AR-cote (Premium) | $55 | $55 |
| All Other Coatings | $42 | $42 |
| Scratch Resistant (Plastic) | $22 | $22 |
| Hi-index (1.56) | $45 | $60 |
| Polycarbonate | $45 | $60 |
| Slab-Off | $60 | $60 |
| Oversize (56mm ED) (Where applicable) |
$20 | $20 |
| UV-400 | $15 | $15 |
| B/F 35mm-Exec. | $45 | |
| T/F 35mm-Exec. | $65 | |
| Progressive (Generic) (Plastic) (i.e. Sola, XL or VIP) |
$115 | |
| Progressive (Premium) | UCR | |
| Progressive (Transitions) (Generic) (Plastic) | $190 | |
| Progressive Transitions Premium | UCR | |
| Blended Bifocal | $70 | |
| Remove Tint (retint) (Plastic) | $20 | $20 |
| Higher Powers: | ||
| +/- 6.25D - +/- 8.00D (per lens) |
$18 | $22 |
| +/- 8.25D - +/- 11.00D (per lens) |
$30 | $36 |
| Over +/- 11.00D (per .5D per lens) |
$4 | $6 |
| Adds +3.25 - 4.00D (per lens) |
$14 | |
| Cylinder +/- 3.25D or more (per lens) |
$14 | $18 |
| Prism (per D, per lens) |
$8 | $8 |
| if patient/member desires, 2nd set of lenses/frames or both please consult your Doctor for possible discount. | ||
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| CONTACT LENSES: | ||
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| (if desired in addition to Basic Benefit) C.L. fitting and evaluation (Contact lens fitting means the process that begins after an initial eye examination for contact lenses and ends when a successful fit has been achieved.) | ||
Co-Payment Spherical |
$50 | |
| Co-Payment Toric | $75 | |
| Co-Payment Monovision and Multifocal | $100 | |
| Custom C.L. and Fitting (out of normal power range or design) |
UCR | |
| All Disposable Lenses | -10% UCR | |
| All RGP Lenses | -20% UCR | |
| * For glass lenses please quote UCR fees. | ||
| Items not listed are at UCR | ||
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QualSight Preferred
LASIK Pricing
