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Missouri rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $457 · 10th–90th $339–$7760%20%10th90th$457Professionalmedian $316 · 10th–90th $151–$4070%20%40%10th90th$316$1.0$5.0$20.0$100.0$500.0$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 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $302.00 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
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
$338.84 / $457.09 / $776.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $245.47 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $323.59