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New Hampshire rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $229 · 10th–90th $229–$4680%20%40%90th$229Professionalmedian $282 · 10th–90th $151–$3890%20%10th90th$282$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
$144.54 / $234.42 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $316.23
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $467.74
Well Sense
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $338.84