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Texas rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $355 · 10th–90th $245–$5130%10%20%10th90th$355Professionalmedian $316 · 10th–90th $166–$3980%10%20%10th90th$316$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $323.59 / $398.11
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,754.23 / $2,754.23
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $354.81 / $457.09
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $501.19 / $724.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $354.81 / $457.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $263.03
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09