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New Hampshire rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $1,148 · 10th–90th $447–$1,3800%20%40%10th90th$1,148Professionalmedian $1,000 · 10th–90th $525–$2,2910%20%10th90th$1,000$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
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $707.95 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,230.27 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
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 / $524.81 / $776.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $426.58 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $660.69 / $1,000.00
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,445.44