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Tennessee rates for HCPCS V2623

Prosthetic Eye Plastic Custom (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.62 / $897.62 / $960.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.42 / $897.62 / $1,119.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.91 / $969.64 / $969.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.14 / $517.14 / $517.14
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,086.55 / $5,682.97 / $6,823.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,994.61 / $8,186.49 / $10,432.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.33 / $526.28 / $768.41