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Prosthetic Eye, Plastic, Custom

Utah 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 Utah, 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 $490 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$525 to $1,259
FacilityA hospital or hospital-owned outpatient department$490$347 to $1,148

How much rates vary

Facilitymedian $490 · 10th to 90th $347 to $1,148Professionalmedian $1,122 · 10th to 90th $347 to $6,310
$500$1K$2K$5Kfacility $490professional $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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$1,202.26
Typical High
$6,309.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$1,995.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$1,318.26
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$831.76
Typical High
$1,071.52
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,148.15
Typical High
$1,148.15
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$812.83
Typical High
$1,445.44
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Select Health
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$1,174.90
Typical High
$1,318.26
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,174.90
Typical High
$1,584.89
United
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$630.96
Typical High
$851.14
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$537.03
Typical High
$851.14

Where Utah 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.

Utah· 9th 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.