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Arizona rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $324 · 10th–90th $166–$4470%20%10th90th$324Professionalmedian $316 · 10th–90th $151–$3980%20%10th90th$316$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $316.23 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $269.15 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $323.59 / $446.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $181.97 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $263.03