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Pennsylvania rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $933 · 10th–90th $776$1,4790%20%40%10th90th$933Professionalmedian $832 · 10th–90th $490$1,2020%20%40%10th90th$832$1.0$10.0$100.0$1.0K$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
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $851.14 / $1,202.26
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $870.96 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,862.09 / $2,691.53
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $776.25 / $1,096.48
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,801.89
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $870.96 / $977.24
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $1,905.46 / $2,754.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,023.29
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,479.11 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $537.03 / $1,122.02