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Fabrication and Fitting of Ocular Conformer

Washington rates for HCPCS V2628

Fabrication and fitting of ocular conformer

Rates data updated July 2026.

Facilitymedian $479 · 10th–90th $257$9770%10%20%10th90th$479Professionalmedian $316 · 10th–90th $151$4790%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
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$316.23
Typical High
$398.11
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$446.68
Typical High
$1,047.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$436.52
Typical High
$794.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$407.38
Typical High
$407.38
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$489.78
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$478.63
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$181.97
Typical High
$346.74
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$426.58
Typical High
$426.58