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Utah rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $776 · 10th–90th $347–$1,1480%20%40%10th90th$776Professionalmedian $1,122 · 10th–90th $347–$6,3100%20%10th90th$1,122$10.0$50.0$200.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $1,122.02 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,318.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $831.76 / $1,071.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,148.15 / $1,148.15
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $1,445.44
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,318.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,174.90 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $489.78 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $537.03 / $912.01