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Ohio rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $513 · 10th–90th $513–$5130%50%100%$513Professionalmedian $282 · 10th–90th $151–$3980%10%20%10th90th$282$50.0$100.0$200.0$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $302.00 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $263.03 / $467.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $363.08 / $501.19
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $177.83 / $218.78