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Missouri rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $1,148 · 10th–90th $676–$2,5120%20%10th90th$1,148Professionalmedian $933 · 10th–90th $550–$2,2910%20%10th90th$933$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $2,089.30 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,122.02 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $575.44 / $7,943.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $954.99 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $562.34 / $912.01