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Pennsylvania rates for HCPCS V2624

Polishing/resurfacing of ocular prosthesis

Facilitymedian $100 · 10th–90th $100–$1290%50%90th$100Professionalmedian $60 · 10th–90th $32–$850%10%20%10th90th$60$1.0$5.0$20.0$100.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $85.11
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $162.18
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $75.86 / $100.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $85.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $7.59
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $69.18 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $67.61