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Pennsylvania rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $372 · 10th–90th $372–$6760%50%90th$372Professionalmedian $309 · 10th–90th $151–$3980%20%10th90th$309$1.0$5.0$20.0$100.0$500.0$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 / $316.23 / $398.11
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $549.54 / $812.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $371.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $309.03 / $398.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $257.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $288.40