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Enlargement of Ocular Prosthesis

Wisconsin rates for HCPCS V2625

Enlargement of ocular prosthesis

Rates data updated July 2026.

Facilitymedian $575 · 10th–90th $479$1,9050%20%10th90th$575Professionalmedian $417 · 10th–90th $182$7080%10%10th90th$417$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$389.05
Typical High
$489.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,905.46
Typical High
$2,754.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$831.76
Typical High
$1,122.02
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$489.78
Typical High
$575.44
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$707.95
Typical High
$1,047.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$512.86
Typical High
$891.25
Medica
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$275.42
Typical High
$537.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$70.79
Network Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$891.25
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$489.78
Typical High
$575.44
Quartz
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$812.83
Typical High
$1,318.26
Quartz
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$2,398.83
Quartz
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$870.96
Typical High
$3,019.95
Security Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$269.15
Typical High
$436.52