go back

Fabrication and Fitting of Ocular Conformer

Pennsylvania rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Rates data updated July 2026.

Facilitymedian $1,122 · 10th–90th $372$1,4450%20%10th90th$1,122Professionalmedian $295 · 10th–90th $151$3800%20%10th90th$295$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
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$316.23
Typical High
$398.11
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$549.54
Typical High
$812.83
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$371.54
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$309.03
Typical High
$380.19
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,122.02
Typical High
$1,445.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$346.74
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$302.00