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Montana rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $1,122 · 10th–90th $776–$1,8620%20%10th90th$1,122Professionalmedian $1,072 · 10th–90th $537–$1,3800%10%10th90th$1,072$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,318.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $776.25 / $851.14
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,122.02 / $2,187.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,122.02 / $2,187.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $1,023.29 / $1,862.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $630.96 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $537.03 / $812.83