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Wisconsin rates for HCPCS V2624

Polishing/resurfacing of ocular prosthesis

Facilitymedian $72 · 10th–90th $60$2630%20%10th90th$72Professionalmedian $62 · 10th–90th $33$1070%10%20%10th90th$62$50.0$100.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $58.88 / $79.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $229.09 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $107.15 / $141.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $61.66 / $75.86
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $89.13 / $114.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $69.18 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $67.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $112.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $218.78
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $380.19
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $331.13 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $54.95