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Maine rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $871 · 10th–90th $871–$8710%50%100%$871Professionalmedian $316 · 10th–90th $178–$3980%20%10th90th$316$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $177.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $316.23 / $316.23