go back

New Mexico rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.79 / $372.17 / $397.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,504.05 / $1,772.35 / $1,849.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.28 / $175.28 / $175.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.46 / $516.46 / $737.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.56 / $339.82 / $395.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.28 / $175.28 / $426.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.44 / $182.18 / $274.43