go back

Missouri rates for HCPCS V2623

Prosthetic eye, plastic, custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$809.36 / $828.43 / $1,104.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$828.43 / $861.56 / $2,400.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,160.49 / $1,218.51 / $5,356.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.14 / $2,100.00 / $2,310.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.14 / $517.14 / $517.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.57 / $1,104.57 / $5,682.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.31 / $578.95 / $1,395.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.85 / $578.95 / $1,028.10