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Minnesota rates for HCPCS V2623

Prosthetic eye, plastic, custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.98 / $947.98 / $947.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$721.60 / $947.98 / $972.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,018.69 / $1,280.00 / $2,426.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.00 / $2,470.00 / $2,600.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,403.30 / $4,031.22 / $9,697.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.13 / $1,390.85 / $1,666.40
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,072.92 / $3,350.03 / $7,635.94
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,312.13 / $1,312.13 / $1,350.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.41 / $1,131.79 / $5,682.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.33 / $564.64 / $1,358.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.33 / $593.90 / $1,471.33