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Washington rates for HCPCS V2623

Prosthetic eye, plastic, custom

Facilitymedian $1,380 · 10th–90th $1,047–$3,0900%20%10th90th$1,380Professionalmedian $1,047 · 10th–90th $513–$1,8620%10%10th90th$1,047$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $933.25 / $1,202.26
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,258.93 / $1,258.93
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,737.80 / $3,715.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,659.59 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $891.25 / $1,096.48
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,258.93 / $1,288.25
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,949.84 / $2,570.40
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,258.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,778.28 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $1,023.29
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,122.02 / $2,290.87