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Prosthetic Eye, Plastic, Custom

South Dakota rates for HCPCS V2623

Prosthetic eye, plastic, custom

Rates data updated July 2026.

How much does Prosthetic Eye, Plastic, Custom cost?

$1,122

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $1,122 for this service. The price depends on where it is billed: about $1,122 from a physician practice, and about $1,349 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,122$955 to $1,318
FacilityA hospital or hospital-owned outpatient department$1,349$955 to $1,862

How much rates vary

Facilitymedian $1,349 · 10th to 90th $776 to $2,239Professionalmedian $1,122 · 10th to 90th $955 to $1,622
$500$1K$2K$5Kfacility $1,349professional $1,122

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$977.24
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$1,288.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,621.81
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,584.89
Typical High
$3,019.95
Medica
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$724.44
Typical High
$7,943.28
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,288.25
Typical High
$1,288.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,148.15
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$630.96
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$891.25
Typical High
$1,318.26
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21

Where South Dakota sits

The same service costs 7.6 times more in Hawaii than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 8th of 51

$1,122

HI $4,898VT $646

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.