go back

Montana rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $479 · 10th–90th $316–$5890%20%40%10th90th$479Professionalmedian $347 · 10th–90th $240–$4270%20%10th90th$347$100.0$200.0$500.0$1.0K

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
$251.19 / $346.74 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $478.63 / $588.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $478.63 / $588.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $371.54 / $501.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $275.42