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Fabrication and Fitting of Ocular Conformer

Utah rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Rates data updated July 2026.

Professionalmedian $316 · 10th–90th $151$4170%10%10th90th$316$50.0$100.0$200.0$500.0

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
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$316.23
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$354.81
Typical High
$446.68
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$346.74
Typical High
$426.58
Select Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$501.19
Typical High
$501.19
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$501.19
Typical High
$741.31
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$275.42