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Virginia rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Facilitymedian $288 · 10th–90th $214–$4070%10%10th90th$288Professionalmedian $269 · 10th–90th $151–$3980%10%20%10th90th$269$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
$151.36 / $281.84 / $389.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $467.74 / $812.83
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $354.81 / $446.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $275.42 / $416.87
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $218.78
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $371.54
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $181.97 / $245.47