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Michigan rates for HCPCS V2623

Prosthetic eye, plastic, custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.66 / $2,571.52 / $3,144.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.75 / $915.66 / $915.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,713.04 / $3,413.03 / $6,216.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.20 / $1,131.79 / $1,527.92
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.30 / $700.30 / $735.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.43 / $905.43 / $905.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.44 / $932.67 / $1,456.46
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$802.92 / $2,571.52 / $3,144.96
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.76 / $905.43 / $1,245.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.01 / $837.52 / $963.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.85 / $537.49 / $810.05