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Polishing/Resurfacing of Ocular Prosthesis

Wisconsin rates for HCPCS V2624

Polishing/resurfacing of ocular prosthesis

Rates data updated July 2026.

Facilitymedian $72 · 10th–90th $60$2400%20%10th90th$72Professionalmedian $60 · 10th–90th $33$980%20%10th90th$60$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
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$58.88
Typical High
$79.43
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$239.88
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$107.15
Typical High
$141.25
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$61.66
Typical High
$75.86
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$89.13
Typical High
$114.82
Medica
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$69.18
Typical High
$112.20
Medica
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$36.31
Typical High
$67.61
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$58.88
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$72.44
Typical High
$112.20
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$61.66
Typical High
$75.86
Quartz
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$114.82
Typical High
$218.78
Quartz
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$389.05
Quartz
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$112.20
Typical High
$489.78
Security Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$36.31
Typical High
$54.95