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Vermont rates for HCPCS V2627

Scleral Cover Shell (Special Coverage Instructions Apply. See Cim: 65-3)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.59 / $975.90 / $1,324.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,377.61 / $1,377.61 / $1,546.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.34 / $742.34 / $742.34
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.34 / $742.34 / $742.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.56 / $946.66 / $3,224.48