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Polishing/Resurfacing of Ocular Prosthesis

Montana rates for HCPCS V2624

Polishing/resurfacing of ocular prosthesis

Rates data updated July 2026.

Facilitymedian $91 · 10th–90th $65$1120%50%10th90th$91Professionalmedian $79 · 10th–90th $51$910%50%10th90th$79$50.0$100.0

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
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$79.43
Typical High
$83.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$112.20
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$112.20
Providence
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$74.13
Typical High
$100.00
Providence
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$85.11
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$36.31
Typical High
$54.95