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Nebraska rates for HCPCS V2623

Prosthetic eye, plastic, custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.88 / $938.88 / $938.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$938.88 / $938.88 / $2,400.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,019.96 / $1,121.96 / $1,133.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,276.54 / $1,276.54 / $1,276.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,215.03 / $1,312.13 / $1,640.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.41 / $1,221.03 / $5,682.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.97 / $578.95 / $908.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,155.80 / $1,276.54 / $1,276.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.29 / $1,155.80 / $2,629.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.13 / $578.95 / $843.44